According to a 2019 study, closing the gap in hospice utilization between White and racial/ethnic minority populations would result in cost savings of an estimated $2,105 per Medicare hospice beneficiary, which translates to approximately $270 million annually.

Particularly, Medicare spends around 20% more on Black and Hispanic people than White people in their last year of life which can be attributed to lower hospice utilization and higher hospitalization rates.

This study was not the first to identify racial disparities in hospice care nor the correlation between lower healthcare costs and hospice usage. In fact, research by Mount Sinai’s Icahn School of Medicine, The National Institute on Aging, The Society of Actuaries and additional academic institutions have cited the economic advantages of hospice care.  

With greater access to hospice, minority populations could experience a reduction in healthcare costs, lesser symptom distress, improved outcomes for care givers, and better quality of life.

So, what causes racial disparities in hospice utilization? Various sociodemographic, cultural, and geographic differences deter and/or prevent minorities from enrolling in hospice. Lack of hospice awareness, lack of access, and distrust of the healthcare system are just a few factors cited in the study.

The study also found a significant increase in hospice utilization in states where there are more for-profit hospices. For-profit hospices tend to expend more capital on community outreach and marketing in minority, low-income, and underserved populations.

Considering greater utilization of hospice would result in savings for taxpayer dollars and improved quality of life, Congress should evaluate healthcare policies that improve access to hospice, not hinder it.

Specifically, The Rural Access to Hospice Act (S.1190/H.R.2594) would remove a statutory glitch that limits patient access to hospice care in rural and underserved communities. This noncontroversial legislation would allow physicians at Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) to transition with their patients into hospice. Often times, patients choose to forgo hospice upon hearing that their physician cannot accompany them into this final stage of life, or they are unduly burdened with the task of finding a new physician.

2016 Research found minorities, more-so African Americans and Native Americans, were seen by FQHCs and had service rates with significantly higher growth between 2007 and 2014. Using this analysis, if physicians at FQHCs were permitted to bill and be paid for hospice services, they would expand access to individuals who otherwise might never receive it.  

As advocates, we understand both the cost-effectiveness of hospice and its value for patients and families. Now, it’s just up to us to make sure Congress knows that. TAKE ACTION NOW, to support greater access to hospice care.