Prolific health disparities have driven hospices to implement various strategies to improve diversity, equity and inclusion among underserved patient populations. Some providers say the needle has much farther to go toward equitable access.

End-of-life care models have increasingly diversified to reach a broader range of patients with different beliefs, values and spiritual outlooks, according to Altonia Garrett, COO of Blue Ridge Hospice. Garrett is also executive director of the Virginia-based hospice’s Diversity, Equity, Inclusion and Belonging Committee.

Yet, hospice providers lack a full scope of understanding around the nuanced challenges impeding utilization and the ways to more effectively address unmet patient needs, Garrett said.

“It’s vital that care models are culturally sensitive, recognizing and respecting diverse beliefs and practices surrounding death and dying,” she told Hospice News. “The systemic discrimination and bias faced by marginalized groups can create significant barriers to accessing care. These communities often encounter lower-quality health care, compounded by racism and stigma, which can diminish their likelihood of receiving timely referrals to hospice services.”

Uncovering Barriers to Health Equity in Hospice Care

Some individuals may be hesitant to engage with hospice services due to cultural perceptions, resulting in underutilization and missed opportunities for quality support, Garret said.

White Medicare decedents have long represented the vast majority of individuals utilizing the hospice benefit, though other racial and ethnic groups have seen improvement.

Hospice utilization rates rose by 4.1% among Hispanic populations in 2022, the largest increase across all minority groups that year, reported the National Alliance for Care at Home. An increase of 3.3% of North American Native Medicare decedents utilized hospice services that year, with rises among Black and Asian American populations at 1.9% and 1.8%, respectively, according to the Alliance report.

“[Inequities] shouldn’t be surprising to us, and what we as an industry need to figure out is how do we communicate with individuals sooner on their health care journeys to build that trust and make sure that they are able to access care,” Liz Fowler, president and CEO of Bluegrass Care Navigators, told Hospice News.

Read the full article about health equity in hospice care by Holly Vossel at Hospice News.