Hospices' enrollment policies may contribute to underuse of hospice care in the United States

Melissa D Aldridge Carlson, Colleen L Barry, Emily J. Cherlin, Ruth McCorkle, Elizabeth H. Bradley

Research output: Contribution to journalArticle

Abstract

Hospice use in the United States is growing, but little is known about barriers that terminally ill patients may face when trying to access hospice care. This article reports the results of the first national survey of the enrollment policies of 591 US hospices. The survey revealed that 78 percent of hospices had at least one enrollment policy that may restrict access to care for patients with potentially high-cost medical care needs, such as chemotherapy or total parenteral nutrition. Smaller hospices, for-profit hospices, and hospices in certain regions of the country consistently reported more limited enrollment policies. We observe that hospice providers' own enrollment decisions may be an important contributor to previously observed underuse of hospice by patients and families. Policy changes that should be considered include increasing the Medicare hospice per diem rate for patients with complex needs, which could enable more hospices to expand enrollment.

Original languageEnglish (US)
Pages (from-to)2690-2698
Number of pages9
JournalHealth Affairs
Volume31
Issue number12
DOIs
StatePublished - 2012

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Hospice Care
Hospices
Terminally Ill
Total Parenteral Nutrition
Medicare
Health Care Costs
Patient Care

ASJC Scopus subject areas

  • Health Policy
  • Medicine(all)

Cite this

Hospices' enrollment policies may contribute to underuse of hospice care in the United States. / Carlson, Melissa D Aldridge; Barry, Colleen L; Cherlin, Emily J.; McCorkle, Ruth; Bradley, Elizabeth H.

In: Health Affairs, Vol. 31, No. 12, 2012, p. 2690-2698.

Research output: Contribution to journalArticle

Carlson, Melissa D Aldridge ; Barry, Colleen L ; Cherlin, Emily J. ; McCorkle, Ruth ; Bradley, Elizabeth H. / Hospices' enrollment policies may contribute to underuse of hospice care in the United States. In: Health Affairs. 2012 ; Vol. 31, No. 12. pp. 2690-2698.
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