Reinvigorating Hospice Care through Standards, Data, Branding, and Quality-based Competition

Key Message: Hospice in the U.S. is in crisis. This sober assessment derives from academic studies, government reports, and journalistic exposés. Corrective efforts have so far proven insufficient. Tangible solutions exist. Two seasoned hospice professionals outline four components of a strategic path forward for restoring quality and reliability of hospice services.

Abstract:

Background/Purpose:
Hospice is experiencing serious problems and faces an uncertain future. Quality of hospice care is highly variable. Unethical business practices are common in some regions. Corrective steps have so far proven insufficient.

Approach:
Efforts to safeguard patients and ensure quality and effectiveness of hospice must begin with commitment to zero tolerance for fraudulent business and clinical practices that harm vulnerable patients.

A pragmatic path exists for restoring integrity and reliable quality to hospice which constrains competition among providers based on measurable quality. This approach resolves tensions between non-profit and for-profit segments of the hospice industry. Financial success in this competitive environment depends on readily available information about each program’s structures, processes and outcomes. Components of this strategic approach include setting clear clinical and programmatic standards, making meaningful quality and patient experience data public facing and readily available, and embracing the field’s authentic brand of expert care that foster’s well-being for patients and families.

Implications/Lessons Learned:
Presenters will specify ways that measured quality can drive competition for patient referrals, corporate contracts, and market share. They will illustrate how Standards, Measured Data, and Rebranding can shift business models of hospice care to Quality-based Competition. Discipline specific staffing levels, the core roles and responsibilities of hospice physicians, and response times to urgent needs or clinical crises will be discussed. Recent developments in quality measures and comparative data will be presented with instructions for accessing latest tools. Presenters will conduct a live demonstration of the online National Hospice Locator as an example of a resource for referrers.

References: 1. A Strategic Path Forward for Hospice and Palliative Care, Palliative Medicine Reports, Ira Byock, June 2025. https://www.liebertpub.com/doi/10.1089/pmr.2025.0030
2. CAPC Recommendations for Palliative Care Programs, May 2025. https://www.capc.org/documents/download/946/
3. Core Roles and Responsibilities of Physicians in Hospice Care Journal of Palliative Medicine May 2023. Ira Byock on behalf of signatories https://shorturl.at/VwI3z
4. National Hospice Locator tool a service of Hospice Analytics, Cordt Kassner, https://www.nationalhospicelocator.com/
5. The Measures that Matter in Hospice Care July 2025 – Bob Tavares, et al HealthPivots July 2025 www.hospicemeasuresthatmatter.com