This study estimated the proportion of U.S. nursing homes (NHs) collaborating with Medicare hospices and identified state-level factors associated with this collaboration. Collaboration was classified as present when at least one of a NH's residents dying in July through December, 2000 received hospice. Seventy-six percent of NHs (n = 12,174) had hospice collaborations, with proportions ranging from 37% in Wyoming to 96% in Florida. State-level factors associated with greater collaboration included having a lower proportion of persons 65+ residing in rural areas, lower NH occupancy and larger hospices, and Medicaid NH reimbursement which was not case-mixed and was paid directly to NHs (not to hospices) for hospice-enrolled residents. Considering the high amount of estimated NH/hospice collaboration, care provision by both NHs and hospices appears to be a potentially viable approach for providing comprehensive end-of-life care in the majority of U.S. NHs. Findings suggest the rural composition of a state as well as its policies and healthcare market characteristics either foster or discourage NH/hospice collaboration. © 2004 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
Miller, S. C., & Mor, V. (2004). The opportunity for collaborative care provision: The presence of nursing home/hospice collaborations in the U.S. states. Journal of Pain and Symptom Management, 28(6), 537–547. https://doi.org/10.1016/j.jpainsymman.2004.10.007