VA End-of-Life Care Push Increases Hospice Use Among Veterans

By Brenda L. Mooney

Chief Master Sgt. Jessica Bender thanked Air Force veteran Ed Redmond, a former crew chief, for his service at the Hunter Homes McQuire VA Palliative Care unit in 2015. VA photo by Steve Goetsch

PROVIDENCE, RI — An intense effort by the VA to improve end-of-life care is paying off, with hospice use increasing more among veterans than nonveterans.

A new report found that hospice use for nonveteran Medicare beneficiaries rose 5.6% between the pre-initiative period—fiscal years 2007 and 2008—and the post-initiative period—fiscal years 2010 to 2014.

At the same time, however, the increase was 7.6% among veterans who only used VA care, 6.9% among those who were dually enrolled in Medicare but used VA care, 7.6% among veterans who received healthcare from both VA and Medicare and 7.9% among dually enrolled veterans who used Medicare.

The recent study in the journal Health Affairs found that a VA program, the four-year Comprehensive End-of-Life Care (CELC) initiative beginning in 2009,  successfully led to more hospice use among military veterans and at a higher growth rate than Medicare.1

As part of the initiative, the VA funded new inpatient hospice units, palliative care staff and palliative care training, while promoting mentoring for leaders and staff, a systematic quality monitoring program, and outreach to community providers outside VAMCs through the “We Honor Veterans” campaign.

Researchers from Brown University and the VA, including the Geriatrics and Extended Care Data Analysis Center, evaluated the effort at the agency’s request. They analyzed the trend in hospice use among more than a million male veterans age 65 and older between 2007 and 2014, and compared that rate of growth to demographically similar Medicare beneficiaries not enrolled in VA care.

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