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Rural Hospice and Palliative Care – Resources

Selected recent or important resources focusing on Rural Hospice and Palliative Care.

Transitional Palliative Care for Family Caregivers: Outcomes From a Randomized Controlled Trial
Examines the influence of mentoring from a palliative care nurse on family caregivers in rural and other areas of three states. Analyzes adult caregivers from 2018-2022 after their care recipient who utilized inpatient palliative care was discharged from the hospital. Compares a control group who received only monthly phone calls with an intervention group who received teaching, guidance, and counseling. Discusses importance of both caregiver support and patient wellness.
Author(s): Joan M. Griffin, Jay N. Mandrekar, Catherine E. Vanderboom, et al.
Citation: Journal of Pain and Symptom Management, 68(5), 456-466
Date: 11/2024
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Palliative Care in Rural Communities
Presents the CARE (Complex, Access, Resourceful, Extraordinary) Framework to highlight the challenges and benefits of healthcare delivery in rural communities. Highlights multiple models for palliative care outside acute care settings with consideration for the CARE Framework.
Author(s): Tracy Fasolino, Kathleen Valentine, Megan E. Mayfield, William E. Rosa, Anne Koci
Citation: American Journal of Nursing, 128(4), 50-55
Date: 07/2024
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Standing Technical Expert Panel for the Development, Evaluation, and Maintenance of Post-Acute Care (PAC) and Hospice Quality Reporting Program (QRP) Measurement Sets: Summary Report
Describes a December 15, 2023, Technical Expert Panel (TEP) regarding the development of additional cross-setting measures for the Post-Acute Care (PAC) and Hospice Quality Reporting Programs (QRPs), and filling measurement gaps with the Centers for Medicare & Medicaid Services (CMS) Universal Foundation measures. Summarizes TEP comments on adding measures to PAC and Hospice QRPs in four domains: 1) behavioral and mental health, 2) patient experience of care, 3) pain management, and 4) immunization. Covers panelists' discussions on the appropriateness of the existing measure set and potential new measures, setting-specific considerations, data sources, and other topics related to each domain. Includes rural references throughout.
Date: 07/2024
Sponsoring organizations: Abt Associates, Acumen, Centers for Medicare and Medicaid Services
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Healthcare Use and Out-of-Pocket Costs for Rural Family Caregivers and Care Recipients in a Randomized Controlled Trial
Evaluates the effect of a transitional palliative care intervention on healthcare utilization and out-of-pocket spending for 282 groups of rural family caregivers and their care recipients in Minnesota, Wisconsin, and Iowa.
Author(s): Brystana G. Kaufman, Ro W. Huang, Diane E. Holland, et al.
Citation: Journal of the American Geriatric Society, 72(8), 2523-2531
Date: 05/2024
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Evaluation of the Medicare Care Choices Model: Fifth and Final Annual Evaluation Report
Evaluates the Medicare Care Choice Model (MCCM), which tests whether offering eligible Medicare beneficiaries the option to receive supportive services without forgoing payment for treatment of their terminal conditions improved their quality of life and care, increased patient and family satisfaction, and reduced Medicare expenditures. Describes the characteristics of participating hospices and withdrawal of providers over time; beneficiaries who were referred to, eligible for, and enrolled in MCCM; services provided and the quality of service delivery; transitions from MCCM to the Medicare hospice benefit; beneficiary outcomes and effects across subgroups; and key findings. Includes information on rural provider and beneficiary participation in the model and compares rural and urban beneficiary outcomes.
Additional links: Findings at a Glance, Participant Experience & Evaluation Results Video
Date: 11/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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Provision of Hospice Services by Critical Access Hospitals: Strengths and Challenges
Describes the characteristics of Critical Access Hospitals (CAHs) that report providing hospice services by analyzing data from the 2021 American Hospital Association (AHA) annual survey. Presents findings from qualitative interviews with seven CAHs who report providing hospice care, including how CAHs provide hospice services, the advantages CAHs may have when providing end-of-life care, and what CAH-specific barriers exist in providing such care.
Author(s): Robert Barclay, Megan Lahr, Hannah MacDougall, Abigail Wenninger
Date: 10/2023
Sponsoring organization: Flex Monitoring Team
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Medicare Advantage Value-Based Insurance Design Model Phase II: Second Annual Evaluation Report
Presents findings from an evaluation of Phase II of the Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model, which allows participating MA parent organizations to offer supplemental benefits and incentives to beneficiaries, hospice benefits, and wellness and healthcare planning through their MA plans. Summarizes findings from interviews with representatives of participating MA organizations, in-network and out-of-network hospices, and beneficiaries. Covers MA organization and beneficiary implementation experiences, plan enrollment, quality of care, health outcomes, and more, for the VBID Model generally and for the VBID Hospice Benefit Component.
Additional links: Appendices, Findings at a Glance, Hospice Benefit Component Findings at a Glance
Date: 09/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, RAND Corporation
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NHPCO Pediatric Facts and Figure, 2023 Edition
Provides an overview of pediatric hospice and palliative care in the United States. Includes information and data on patient characteristics, access to care, reimbursement, barriers and facilitators to care, and more. Section 3 compares the number and percentage of metropolitan and non-metropolitan counties with access to pediatric hospice and palliative care.
Date: 06/2023
Sponsoring organizations: National Alliance for Care at Home, National Hospice and Palliative Care Organization
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Hospice: CMS Flexibilities to Fight COVID-19
Outlines specific regulatory waivers and Medicare flexibilities for hospice providers issued in response to the COVID-19 pandemic. Includes information on payments for COVID-19 vaccines and therapeutics. Identifies whether each waiver or flexibility has been terminated, will end at the conclusion of the public health emergency, or has become permanent.
Date: 05/2023
Sponsoring organization: Centers for Medicare and Medicaid Services
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Palliative Care and Healthcare Utilization among Metastatic Breast Cancer Patients in U.S. Hospitals
Examines in-patient palliative care use by hospitalized metastatic breast cancer patients. Analyzes 26,961 female patients from 2010 to 2014 for palliative care use, with patient information further broken down by age, race, income, insurance type, and status of hospital utilized, such as urban teaching, urban nonteaching, or rural.
Author(s): Sun Jung Kim, Isha Patel, Chanhyun Park, Dong Yeong Shin, Jongwha Chang
Citation: Scientific Reports,13, 4358
Date: 03/2023
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Last Updated: 1/16/2026