Cutler Institute for Health and Social Policy

Barriers to Medicare Hospice Utilization


This report, prepared for the Maine Hospice Council and funded by the Carpenter Foundation, presents findings of a qualitative study of barriers to hospice utilization. This study includes the perspectives of all 26 Medicare certified hospice providers in Maine. Significant findings of the qualitative study include <li> A continuing need to educate the general public about hospice and the Medicare benefit. <li> Maine health care providers have low referral rates to the hospice programs and often misunderstand the regulations and guidelines of the hospice benefit. <li> The referral process to hospice programs is based on fragile systems of communication, fraught with potential miscues, misunderstandings, and missed opportunities. <li> Providers indicate a strong interest in coming to the table to collectively address the underutilization of the Medicare hospice benefit in Maine. <li> Active consumerism may be an important key to increased dialogue and acceptance of end-of-life care--demand for hospice services may not increase until the consumer is engaged in the conversation. <li> Certain components in the Medicare hospice benefit appear open to varying interpretation and application, causing confusion for consumers and referring physicians, and may be a potential source of tension between certified agencies. <li> Significant workforce issues impact the ability of Maine hospice programs to meet even the current demand for services. <li> Provision of hospice in long-term care facilities is both an opportunity and a challenge.</li>

Publication Type: 
Publish Date: 
December 13, 2007