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Weekly Tips & Insights

Top Hospice Trends of 2023

Updated: Jan 30, 2023

Every year, the landscape of hospice care evolves, and the Visiting Nurse Association of Greater St. Louis (VNA) is always reviewing those trends. Here are some key trends for 2023:

What Is Hospice Care?

Hospice care is end-of-life medical and emotional care for patients faced with terminal illnesses along with help and support for their caregivers.

While under hospice care from VNA specifically, patients receive:

  • ​A specially trained staff to deal with the symptoms and emotional needs at the end of life.

  • Medications and medical equipment.

  • Volunteers, both people and sometimes pets, to help with stress and loneliness.

  • Physician guided care and ease of obtaining needed medications.

  • Bereavement care for 13 months following the death of a loved one.

  • RN care, which is available 24 hours a day by phone and by visit if needed.

To qualify for hospice care, a hospice care doctor or your primary care physician must certify that you’re terminally ill, meaning you have a life expectancy of six months or less. When you agree to hospice care, you’re agreeing to comfort care instead of care to cure your illness.

Hospice Care Demographic Trends

According to the NHPCO Fact and Figures 2022 Edition, Medicare hospice users have increased steadily between 2016 and 2020. 52.7% of Medicare decedents who used hospice identified as female while 42.9% identified as male. 59% of Medicare decedents were over the age of 85 with just 26.5% under the age of 65.

In 2020, the most common diagnoses of Medicare decedents on hospice were Alzheimers, dementia, and Parkinsons (18.5%), with circulatory/heart diseases in second (9.3%). Hospice care patients on average stayed in hospice care for 97 days, which was a 4.5 day increase, the largest increase in the previous five years.

Integration of Care Services

VNA coordinates care between departments within VNA and with outside healthcare providers. There will be pressure in 2023 for other hospice providers to do the same and even potentially diversify services within their own walls. Outside those walls, there may be an increase in joint ventures between hospice care providers and health systems.

New Hospice Care Regulations

Government oversight of hospice care providers will likely tighten during 2023, mostly targeted toward avoiding fraud on behalf of hospice providers, or providers admitting people who don’t need hospice and providing quick care instead of quality care.

While there are no specific new quality measures in the Centers for Medicare & Medicaid Services’ (CMS) FY 2023 Final Rule, ongoing testing and review of the Hospice Outcomes and Patient Evaluation (HOPE) tool, “an ongoing patient assessment instrument designed to capture patient and family care needs throughout the hospice stay,” will continue through 2023. This could lead to future quality measure developments.

While nothing is certain, it’s important hospice providers stay aware of what could be coming their way. For more information regarding VNA’s hospice care services, visit or contact Carol Emmerich, RN, at (314) 918-7171, ext. 1322 or


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