Hospice is the dominant model of care for seriously ill people at the end of life. While the Medicare hospice benefit was originally designed around a cancer disease paradigm, it increasingly serves people living with dementia.

Now, almost half of all older adults receiving hospice care have dementia.

In the June 2022 issue of Health Affairs, Krista Harrison and coauthors examine the quality of end-of-life care at the population level.

Using nationally representative data from 2011–17, the authors determine that proxies of hospice-enrolled people living with dementia are more likely to rate last-month-of life care as excellent compared with proxies of people living with dementia who did not enroll with hospice.

Harrison and coauthors observe no differences in hospice ratings when comparing people with or without dementia.

The findings of the study present implications for policy makers when weighing changes to hospice policy and regulations that may affect people living with dementia.

To read the article and others like it, subscribe to Health Affairs.

Today in Health Affairs Forefront, Katie Keith summarizes the status of the lawsuits filed by health care providers over the No Surprises Act (NSA) and recent guidance from the Biden administration on implementation of the law.

Richard Gilfillan and Donald Berwick discuss two critical responses to their September 2021 Health Affairs Forefront articles on the "Medicare Advantage Money Machine."

James Capretta argues that reforms to Medicare’s two-part trust fund design should ensure total Medicare expenditures are matched with sources of funding that do not presume ever-increasing levels of federal debt.

Chris DeRienzo and Ronald Paulus write about how to define and measure unnecessary care variation in order to deliver patient-centered care.

Elevating Voices: Pride Month: In his March 2022 Narrative Matters essay, Richard Sorian discusses lessons learned from communicating about the HIV/AIDS pandemic and current failures to talk effectively about COVID-19.

About Health Affairs

Health Affairs is the leading peer-reviewed journal at the intersection of health, health care, and policy. Published monthly by Project HOPE, the journal is available in print and online. Late-breaking content is also found through healthaffairs.org, Health Affairs Today, and Health Affairs Sunday Update.

Project HOPE is a global health and humanitarian relief organization that places power in the hands of local health care workers to save lives across the globe. Project HOPE has published Health Affairs since 1981.

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