Hospices Employ Gap Analyses to Build Palliative Care Programs

An assessment of community needs is essential for hospices working to establish or grow their palliative care programs. Providers need to understand the population that they serve in terms of demographics, culture and the availability of palliative care and other health care services in that region.

While no standardized definition exists for “palliative care,” the U.S. Centers for Medicare & Medicaid Services (CMS) defines the term as “patient and family-centered care that optimizes quality of life by anticipating, preventing and treating suffering. Palliative care throughout the continuum of illness involves addressing physical, intellectual, emotional, social and spiritual needs and to facilitate patient autonomy, access to information and choice.”

Palliative services remain widely underutilized throughout the globe. The United States ranks among the lowest nations in duration of palliative care for people with life-limiting and terminal illnesses, according to a World Health Organization report last year, though a growing number of hospices are diversifying their business lines to include this service.


“Palliative care is growing exponentially, [and] it’s important to know who is going to influence your business,” Zaundra Ellis, director of hospice solutions for health care software provider Axxess, told Hospice News in a recent webinar. “Look at some of your strongest partnerships that you’re interested in growing and examine how palliative care would affect those relationships to help identify where there might be the most significant gap to fill.”

A careful gap analysis can help hospices get a feel for what kind of services the community needs, as well as the competitive landscape, while identifying patients who may have fallen through the cracks of the health care system.

Among the considerations involved in a hospice’s gap analysis is recognizing the actual versus potential palliative care needs in a given market. Digging into data on population demographics such as age, race and socioeconomic status can reveal indicators of the gaps within a community that palliative care providers can fill. Taking care to consider the needs of underserved communities is an important step. Race, ethnicity and socioeconomic status are the leading differentiating barriers fueling disparities in hospice and palliative care utilization.


Close to 60% of patients who would benefit from palliative care do not receive those services, whether they are in a hospital or in their homes, according to a recent report from the New England Journal of Medicine Catalyst Insights Council.

Gaining a bigger picture of the other health care providers in a hospice organization’s service region can help identify key growth areas and potential referral partnerships.

“You want to analyze the current state of palliative care programming and do some research to understand what the needs of your community are,” Ellis said.“In the beginning, it’s really about quality over revenue, so you want to make sure in whichever model you choose that you’re going to be able to provide the highest level of that palliative care to patients that you’re serving.”

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