Cutler Institute for Health and Social Policy

Population Health and Health 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

Nellie Mae Education Foundation nominates Pious Ali for the Lawrence W. O'Toole Award

Pious Ali

Pious Ali, Youth and Community Engagement Specialist in Cutler’s Children, Youth, and Families Programs, has been nominated for the Lawrence W. O’Toole Award by the Nellie Mae Education Foundation. Pious is one of six nominees from the New England states.

The Nellie Mae Education Foundation believes that student-centered learning – where learning is personalized, engaging, competency-based and not restricted to the classroom – will prepare young people to graduate high school ready to contribute to their communities and succeed. This award is given out each year to an individual, school district, or non-profit that has exhibited great leadership in moving student-centered approaches to learning forward in the New England region.

The winner will be selected by online voting and will be awarded a $100,000 grant to help advance student centered learning!


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