Document Type


Publication Date



Hospice, Hospice benefits, Hospice - Medicare, Hospice - regulations, Cutler Institute, Population Health and Health Policy, USM Aging Initiative, Health and Wellness


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: A continuing need to educate the general public about hospice and the Medicare benefit. Maine health care providers have low referral rates to the hospice programs and often misunderstand the regulations and guidelines of the hospice benefit. The referral process to hospice programs is based on fragile systems of communication, fraught with potential miscues, misunderstandings, and missed opportunities. Providers indicate a strong interest in coming to the table to collectively address the underutilization of the Medicare hospice benefit in Maine. 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. 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. Significant workforce issues impact the ability of Maine hospice programs to meet even the current demand for services. Provision of hospice in long-term care facilities is both an opportunity and a challenge.

Funding Organization

Funded by the Carpenter Foundation



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