A comparison of hospice programs based on Medicare certification status

Area of Science:

• Palliative Care
• Healthcare Management
• Health Services Research

Background:

• Hospice care is a vital component of end-of-life care.
• Medicare certification significantly impacts healthcare providers.
• Understanding differences between certified and non-certified hospice programs is crucial for policy and practice.

Purpose of the Study:

• To investigate the characteristics and operational differences of Medicare-certified versus non-certified hospice programs in the U.S.
• To identify perceived advantages and disadvantages of Medicare certification for hospice programs.
• To examine potential access barriers and staff perceptions in certified and non-certified hospice settings.

Main Methods:

• A study involving 119 U.S. hospice programs.
• Data collection through personal interviews and questionnaires with program directors, nurses, social workers, and chaplains.
• Comparative analysis of characteristics, services, and staff perceptions between certified and non-certified programs.

Main Results:

• Medicare-certified hospice programs reported longer patient lengths of stay.
• Certified programs were more likely to have nurses on the first visit and bill patients more frequently.
• Volunteer utilization was lower in Medicare-certified programs, which also emphasized patients' medical needs more strongly.

Conclusions:

• Medicare certification appears to correlate with a more medically-oriented model of palliative care.
• Differences in operational aspects and patient focus exist between certified and non-certified hospice programs.
• Findings suggest Medicare certification may influence the structure and delivery of hospice services.