Hospices have opened doors to some of the most innovative opportunities around community and public education to help dispel barriers to greater awareness of their services.

The ability to increase public awareness and community education efforts was cited as the third top concern by 16% of 112 hospice professionals who participated in this year’s Outlook Survey by Hospice News and Homecare Homebase. This challenge superseded consolidation trends in the hospice market and changing payment dynamics.

The second piece of this three-part Hospice News series will explore the leading issues in hospice marketing and community outreach in 2025. Providers have greater opportunities to expand their reach now than they ever have historically, indicated Debbie Shumway, executive director at Arizona-based Hospice of the Valley.

“There’s real opportunities out there for hospices, and we’re just barely scratching the surface,” Shumway told Hospice News. “[It’s] thinking of how the next generation of employees, family caregivers and volunteers receive and process information. How do we need to change what we’re doing now to make sure we’re reaching them in a way that they can digest information? Social media can be an important opportunity, and we can tap into that resource in really fun ways.”

Photo by Hospice News

News ways of breaking down old barriers

The difficulty of spreading accurate information about hospice care delivery has long plagued providers. A common misperception is that these services are for patients at the “brink-of-death”, rather than being accessible to terminally ill patients with a six-month life expectancy.

Hospices’ mythbusting strategies have evolved in recent years to dispel misunderstandings among other health care providers and patients alike.

Among the significant factors helping to move the needle forward on public awareness came with the passing of former President Carter late last year. James Earl Carter Jr. was essential to the establishment of the Medicare Hospice Benefit in 1983. His administration launched the U.S. Centers for Medicare & Medicaid Services’ (CMS) demonstration project to test the model, leading to passage of a law establishing the benefit during the subsequent Reagan presidency.

Carter’s hospice experience illustrated a tremendous need for change around end-of-life care delivery while elevating a larger conversation about these services in the public eye, according to a spokesperson at Enhabit Inc. (NYSE: EHAB).

“It is often reiterated that providers now have a notable example in former President Jimmy Carter, who received hospice care for nearly two years,” an Enhabit spokesperson told Hospice News in an email. “We believe we need a bold public education initiative to increase awareness of the benefits of hospice and end-of-life care planning.”

Carter’s experience did more to shine the light on the benefits of hospice care than “anything any of the providers could have done,” said Robert Love, executive director of California-based Butte Home Health & Hospice.

The hospice industry as a whole has “collectively held its breath” whenever a public figure’s election of the hospice benefit is announced, Love indicated. This is largely because their hospice election usually happens in the last few days of life, as it commonly does among many patients nationwide. The trend of short hospice stays has damaged public perception and misshapen the outlook of what these services actually entail, he added.

Having a very public example of how beneficial hospice can be when accessed upstream in an illness has spoken volumes to communities across the country, Love said.

“[Carter’s] very public and very early election of hospice helped open the door for better awareness and better discussion around hospice,” Love told Hospice News in an email. “What he did for the public awareness of the industry, and for millions of patients and families who will benefit is beyond measure. If you get a think-tank together centered around public awareness, someone always suggests a public awareness campaign. We’ve tried this in the past, and it’s expensive and largely ineffective.”

Data have also become increasingly important tools in communicating the benefits of hospice care at wider public levels. A growing volume of studies have pointed to the cost-savings potential and quality impacts of hospice utilization.

Among the most significant data was a report finding that longer hospice stays have reduced health care costs in the last year of life by as much as 11%. The report was a joint effort from the National Alliance for Care at Home and NORC at the University of Chicago.

Regardless of length of stay, hospice saves Medicare roughly $3.5 billion for patients in their last year of life, with stays of six months or more yielding the highest savings.

“[The study] demonstrated that hospice care results in cost savings for the Medicare program, even after six months,” an Enhabit spokesperson said. “Although this study received limited attention, we hope the current administration will recognize the savings and benefits provided by high quality hospice care.”

Strategies gaining momentum

Hospices are finding creative ways to reach broader audiences with messages about the interdisciplinary nature of their services that address patients’ physical, emotional and spiritual needs.

For instance, Hospice of the Valley has implemented a few different outreach strategies including expanded utilization of social media channels to cast a wider net of awareness of their services. Collaborations with local educators has also been an important avenue of increasing community awareness, Shumway stated. The hospice provider has engaged volunteers at high schools and colleges through these partnerships, she stated.

Hospices must have a vigilant and nimble approach to building an organizational culture that speaks for itself as far as staff and patient satisfaction, she indicated.

“It’s always taking that opportunity to constantly be raising awareness about what quality hospice care really is,” Shumway said. “We cannot let off the pedal on that awareness, it’s constant. Whether that’s in your community, with volunteers or engaging medical students with more exposure to hospice and palliative care … Having that knowledge of service is vital.”

Community collaborations are an essential part of successful public awareness strategies. These collaborations are an opportunity for hospices to work with other providers and organizations to gain a deep understanding of the most common challenges their local communities are facing and find creative ways to address them, according to Shumway.

Working in lock step with hospital systems, pharmacists, emergency responders and firefighters, and medical educators can go a long way in spreading the knowledge around the benefits of hospice care, Shumway said.

Another beneficial public outreach pathway can be direct-to-consumer engagement tactics, according to Jen Malko, vice president of business and development at Florida-based Haven Hospice.

Hospices with diversified services and programs can highlight these in ways that help to expand education around options in end-of-life care, Malko said. For example, advance care planning services can be a particularly effective way of individuals’ addressing goals of care and raise awareness around hospice services while also creating valuable opportunities for community connection, she said.

Public awareness campaigns that illustrate how bereavement services and dementia care programs help improve quality of life can also lead to greater discussions about hospice, according to Malko. Hospices that can demonstrate how they go above and beyond to provide goal-concordant care stand to gain a leg up on competing, and sometimes conflicting, misinformation about their services, she said.

“Public awareness often starts with the programs and services we offer outside what is required by Medicare,” Malko told Hospice News in an email. “This kind of community outreach is not only impactful for those who attend, but also identifies us as leaders in end-of-life care and grief support. We raise awareness for these programs, hospice care, and other special programs through a variety of internal and external communication, including targeted social media campaigns.”

Increasing referral outreach can help develop a stronger base of knowledge around hospice’s value proposition among the patients that other health care providers serve upstream, according to Love.

Expanding hospice education among other health care professionals involves having a trusted advocate who can speak to the depth of these services and their impacts on patient outcomes, he stated. This tactic can help ensure that patients receive the right care at the right time in their illness trajectories, Love stated.

“It’s far more efficient to target education at the level [of] teaching providers and professionals how to approach the hospice topic,” Love said. “We can educate, but we’ve had success with offering nurse educators who can talk with families when providers send them to us. Offering this trusted relationship with providers gives them a chance to have honest conversations, but to pass the baton to hospice for a more in-depth conversation. We’ve been more assertive about encouraging healthcare providers to send families our way earlier in the process so they’re equipped with the right education [to] make the right decision when the time is right, and they aren’t having to do it in a time of crisis.”