Milken Institute School of Public Health Poster Presentations (Marvin Center & Video)

Title

Analysis of Policy Barriers to Emergency Medical Service Involvement in Hospice Care

Poster Number

91

Document Type

Poster

Status

Graduate Student - Masters

Abstract Category

Health Policy and Management

Keywords

Hospice, Emergency Medical Services, Policy, Medicare, Mobile Integrated Health

Publication Date

Spring 2018

Abstract

Purpose The life expectancy in the United States is longer than ever before. However, as the Baby Boom generation ages and people die increasingly slow deaths from chronic conditions, there will be a growing need for partnerships and programs to ensure end of life patients get the care they need in the setting that they want. One partnership in particular that has a growing following is that between hospice agencies and the Emergency Medical Services. This paper will examine potential policies at the Federal, State, and systemic levels that hinder or prevent EMS agencies from participating in hospice services. Methods A review of literature was conducted. Academic literature from after 1974 – the date of the first American hospice agency – and grey literature from after 2007 were considered. SCOPUS, CINAHL, and the Himmelfarb Library database were queried with various combinations of MeSH terms. Those results were then screened by date and content for relevance. A variety of government agencies and relevant NGOs were also searched for applicable content. Results Significant barriers to EMS involvement in hospice services exist at the Federal and State levels. At the Federal level, there is a major problem with reimbursement for both EMS and Hospice services with regards to this type of care. The Drug Enforcement Administration also has policy barriers written into the Controlled Substances Act, but there is legislation waiting for the President’s signature that may reverse these barriers. Additional barriers exist on a state by state basis, but these were more difficult to determine, and searching for each independently proved challenging. Conclusion Significant barriers to EMS involvement in Hospice care exist at Federal and State levels. Because some states allow for EMS agencies to provide home health services without transport, and because the major barriers to the federal controlled substance issue is expected to resolve soon, there is an opportunity for further research into EMS / hospice collaboration efficacy given the correct policy conditions. There is also an opportunity to explore novel reimbursement structures and criteria to support these programs and benefit the patient population they serve.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Open Access

1

This document is currently not available here.

Share

COinS
 

Analysis of Policy Barriers to Emergency Medical Service Involvement in Hospice Care

Purpose The life expectancy in the United States is longer than ever before. However, as the Baby Boom generation ages and people die increasingly slow deaths from chronic conditions, there will be a growing need for partnerships and programs to ensure end of life patients get the care they need in the setting that they want. One partnership in particular that has a growing following is that between hospice agencies and the Emergency Medical Services. This paper will examine potential policies at the Federal, State, and systemic levels that hinder or prevent EMS agencies from participating in hospice services. Methods A review of literature was conducted. Academic literature from after 1974 – the date of the first American hospice agency – and grey literature from after 2007 were considered. SCOPUS, CINAHL, and the Himmelfarb Library database were queried with various combinations of MeSH terms. Those results were then screened by date and content for relevance. A variety of government agencies and relevant NGOs were also searched for applicable content. Results Significant barriers to EMS involvement in hospice services exist at the Federal and State levels. At the Federal level, there is a major problem with reimbursement for both EMS and Hospice services with regards to this type of care. The Drug Enforcement Administration also has policy barriers written into the Controlled Substances Act, but there is legislation waiting for the President’s signature that may reverse these barriers. Additional barriers exist on a state by state basis, but these were more difficult to determine, and searching for each independently proved challenging. Conclusion Significant barriers to EMS involvement in Hospice care exist at Federal and State levels. Because some states allow for EMS agencies to provide home health services without transport, and because the major barriers to the federal controlled substance issue is expected to resolve soon, there is an opportunity for further research into EMS / hospice collaboration efficacy given the correct policy conditions. There is also an opportunity to explore novel reimbursement structures and criteria to support these programs and benefit the patient population they serve.