Rural Health
Resources by Topic: Hospice and palliative care
Clinician Perceptions of Barriers and Facilitators for Delivering Early Integrated Palliative Care via Telehealth
Presents results from a survey on barriers, facilitators, and benefits of telehealth use for early integrated palliative care (EIPC). Survey participants were 48 clinicians providing palliative care services to patients with advanced lung cancer. Discusses clinician attitudes, logistical and organizational influences, and patient characteristics affecting access. Highlights barriers experienced by elderly, rural, and under-resourced populations.
Author(s): Katrina Grace Sadang, Joely A. Centracchio, Yael Turk, et al.
Citation: Cancers, 15(22), 5340
Date: 11/2023
Type: Document
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Presents results from a survey on barriers, facilitators, and benefits of telehealth use for early integrated palliative care (EIPC). Survey participants were 48 clinicians providing palliative care services to patients with advanced lung cancer. Discusses clinician attitudes, logistical and organizational influences, and patient characteristics affecting access. Highlights barriers experienced by elderly, rural, and under-resourced populations.
Author(s): Katrina Grace Sadang, Joely A. Centracchio, Yael Turk, et al.
Citation: Cancers, 15(22), 5340
Date: 11/2023
Type: Document
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November 2023 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) November 2023 meeting. Covers the Rural Emergency Hospital (REH) designation, dual-eligible special needs plans (D-SNPs), MedPAC's proposed work plan on hospice and end-of-life care, Medicare coverage and payment for software as a medical service, and access and favorable selection in Medicare Advantage. Includes rural references and considerations throughout.
Date: 11/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) November 2023 meeting. Covers the Rural Emergency Hospital (REH) designation, dual-eligible special needs plans (D-SNPs), MedPAC's proposed work plan on hospice and end-of-life care, Medicare coverage and payment for software as a medical service, and access and favorable selection in Medicare Advantage. Includes rural references and considerations throughout.
Date: 11/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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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
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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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
Type: Document
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
Type: Document
Sponsoring organization: Flex Monitoring Team
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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
Type: Document
Sponsoring organization: Flex Monitoring Team
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MedPAC Payment Basics
Series of briefs providing an of Medicare payment systems. Covers payments systems including Accountable Care Organizations (ACO), Critical Access Hospitals (CAH), Federally Qualified Health Centers and Rural Health Clinics, hospital acute inpatient services, and more.
Date: 10/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Series of briefs providing an of Medicare payment systems. Covers payments systems including Accountable Care Organizations (ACO), Critical Access Hospitals (CAH), Federally Qualified Health Centers and Rural Health Clinics, hospital acute inpatient services, and more.
Date: 10/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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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
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RAND Corporation
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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
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RAND Corporation
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MedPAC Comment on CMS's Proposed Rule on the Home Health Prospective Payment System for FY 2024
Comments on a July 10, 2023, Federal Register proposed rule related to Medicare payment policies for home health agencies. Includes comments on expanding the Home Health Value-Based Purchasing Model nationwide, wage index adjustments, the Hospice Special Focus Program (SFP), and more.
Date: 08/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a July 10, 2023, Federal Register proposed rule related to Medicare payment policies for home health agencies. Includes comments on expanding the Home Health Value-Based Purchasing Model nationwide, wage index adjustments, the Hospice Special Focus Program (SFP), and more.
Date: 08/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Palliative Care Needs and Preferences of Older Adults with Advanced or Serious Chronic Illnesses and their Families in Rural Communities of Indiana, USA
Presents the experiences of caregivers in rural Indiana related to palliative care, the needs of older adults with chronic illnesses, and the impacts on their families. Discusses themes such as managing pain, caregiver trust, distance and access to care, managing difficult conversations, caregiver burden, and use of telehealth in rural areas.
Author(s): Nasreen Lalani, Kawther Hamash, Yitong Wang
Citation: Journal of Rural Health, 40(2), 368-375
Date: 08/2023
Type: Document
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Presents the experiences of caregivers in rural Indiana related to palliative care, the needs of older adults with chronic illnesses, and the impacts on their families. Discusses themes such as managing pain, caregiver trust, distance and access to care, managing difficult conversations, caregiver burden, and use of telehealth in rural areas.
Author(s): Nasreen Lalani, Kawther Hamash, Yitong Wang
Citation: Journal of Rural Health, 40(2), 368-375
Date: 08/2023
Type: Document
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Texans' Views and Experiences with End-of-Life Issues
Survey of 2,305 Texans regarding attitudes, experiences, and needs around illness and end-of-life issues. Discusses barriers to access of end-of-life care, race and ethnicity, insurance status, and more. Includes rural data throughout.
Additional links: Research Summary
Date: 06/2023
Type: Document
Sponsoring organizations: Perry Undem, St. David's Foundation
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Survey of 2,305 Texans regarding attitudes, experiences, and needs around illness and end-of-life issues. Discusses barriers to access of end-of-life care, race and ethnicity, insurance status, and more. Includes rural data throughout.
Additional links: Research Summary
Date: 06/2023
Type: Document
Sponsoring organizations: Perry Undem, St. David's Foundation
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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
Type: Document
Sponsoring organization: National Hospice and Palliative Care Organization
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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
Type: Document
Sponsoring organization: National Hospice and Palliative Care Organization
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