FOR IMMEDIATE RELEASE: Thursday, August 7, 2025
CONTACT: Christina Johnson
Tallahassee, Fla. – Today, Florida TaxWatch released Hospice and Palliative Care: Florida is a National Leader Among the States Looked to for Best Practices in Compassionate Care, to ensure Florida’s state policies and practices improve the outcomes of hospice and palliative care for seniors, save taxpayers hard-earned money, and add dignity to our seniors’ quality of life. The latest Centers for Medicare and Medicaid Services data, published November 2024, shows Florida in the top ten rankings for its delivery of hospice services compared to other states.
Florida TaxWatch President and CEO Dominic M. Calabro said, “Florida is a national leader among the states looked to for best practices in compassionate care and Florida TaxWatch over the past decade has written extensively on the value of Florida’s hospice certificate of need and palliative care programs. Palliative care is an upstream form of care that can be implemented earlier in the disease management process, thereby helping to improve a patient’s quality of life and reduce overall healthcare costs for patients and taxpayers alike.”
Florida TaxWatch Executive Vice President and General Counsel Jeff Kottkamp said, “Florida’s patient-centered palliative care programs have been shown to improve patient outcomes and quality of life, while reducing healthcare costs. Still, sufficient levels of palliative care are unavailable in more than one-half of Florida counties. As other states look to Florida, we urge policymakers to retain the certificate of need program in statute and that hospice regulators continue to identify ways that Florida hospice providers can continue to provide high quality care for Floridians.”
Palliative care is an emerging and important part of the care spectrum and should be delivered alongside curative and life-prolonging treatments to reduce suffering from disease or condition, and to ease side effects of curative therapies. In Florida, the expansion of hospice providers is guided by the Certificate of Need (CON) process, in which new hospice providers are approved only if there is a demonstrated unmet need. In areas with unmet needs, providers compete for the opportunity to launch new hospice services.
The CON process helps to ensure the orderly and manageable growth of hospice providers, making it easier for the state to monitor their quality and to ensure that each provider has enough patients to sustain their operations. Utilizing CON has allowed the state to maintain a highly competitive, effective, and quality network of hospice providers. The latest Centers for Medicare and Medicaid Services data, published November 2024, shows Florida in the top ten rankings for its delivery of hospice services compared to other states, and:
- The Hospice and Palliative Care Composite Process Measure gauges patient stays that satisfy applicable criteria for seven categories. Florida is ranked 6th nationwide, with a score of 95.9 percent.
- The Hospice Care Index Overall Score is the average score of hospices that earn points (1-10) for meeting different claims-based indicators. Florida tied 2nd nationwide, with a score of 9.7.
Florida is witnessing an emerging shift to community/home-based palliative care, which has been found to increase patient satisfaction and reduce the use and costs of medical services and facilitate more appropriate and timely utilization of hospice services when the patient approaches end of life. Florida TaxWatch recommends the following:
- Expansion of community/home-based palliative care which may efficiently meet the needs of the growing number of patients that would benefit from palliative care services, improve patient quality of life, and net significant health savings in the long run.
- A regulatory framework that: (a) defines the services that constitute palliative care; (b) establishes minimum levels of service and standards; (c) forms a predictable payment source for providers; (d) establishes regulatory requirements and oversight mechanisms; and (e) removes legal barriers, should be developed.
- Amending Section 464.0123(3) of the Florida Statutes to effectively utilize the APRN workforce in hospice and palliative care facilities that will not only address the current gaps in medical facilities but is also a cost-effective solution for the state to maintain high-quality care at reduced costs.
- Funding pilot projects within the Medicaid program that focus on transitioning terminal patients into hospice care facilities at an earlier stage in their long-term care process that will not only address the sequencing and transitioning challenges but also develops more efficient and productive processes for the continuum of care for patients.
- Retain the CON program in Florida statute, and that hospice regulators continue to identify ways that Florida hospice providers can continue to provide high quality care for Floridians.
Perhaps the most significant challenge to hospice is the threat of repealing the CON program. Critics argue that the average patient in a state governed by CON has access to fewer hospitals, hospice care facilities, dialysis clinics, and ambulatory surgery centers. There are also concerns that CON does not distribute care where it is most lacking, and that many (primarily rural) patients must travel farther for hospice care.
Although CON has helped to create a relatively stable growth rate of newly licensed hospice care facilities in Florida, states without CON have experienced exponential growth in the number of hospice providers. From 2014 to 2020, the number of hospice providers in California increased 67 percent; in Texas, the increase was 23 percent. This exponential growth of new hospice providers has raised several red flags related to fraud. The strong performance of Florida’s hospice CON programs illustrates that state’s success in delivering high-quality hospice care with high utilization rates and minimal fraud.
To learn more please click here.
About Florida TaxWatch
As an independent, nonpartisan, nonprofit government watchdog and taxpayer research institute, and the trusted “eyes and ears” of Florida taxpayers for more than 45 years, Florida TaxWatch (FTW) works to improve the productivity and accountability of Florida government. Its research recommends productivity enhancements and explains the statewide impact of fiscal and economic policies and practices on taxpayers and businesses. FTW is supported by its membership via voluntary, tax-deductible donations and private grants. Donations provide a solid, lasting foundation that has enabled FTW to bring about a more effective, responsive government that is more accountable to, and productive for, the taxpayers it has served since 1979. For more information, please visit www.floridataxwatch.org.
Meet the Author:
