Florida's aging population is driving sustained demand for cost-effective, patient-centered care across the continuum. Palliative care—non-curative, interdisciplinary support for patients with serious but often nonterminal conditions—improves quality of life and can lower overall costs when introduced early in the disease course. Hospice provides end-of-life care once a clinician certifies a terminal prognosis; in Florida, hospice providers operate under a Certificate of Need (CON) program that authorizes new entrants only when unmet need is demonstrated through twice-yearly batching cycles.
Florida's CON-planned network performs among the nation's best—ranked 6th on the Hospice & Palliative Care Composite Process Measure and tied for 2nd on the Hospice Care Index—while serving a large and growing caseload (166,116 hospice patients in 2024; 94 licensed programs operated by 57 providers). Key constraints limit wider access to upstream palliative care. The current reimbursement landscape often fails to cover providers' full costs, and low public awareness slows timely referrals, despite evidence that earlier use improves outcomes. Workforce capacity is another pressure point: a sizable share of physicians are nearing retirement and palliative teams face heightened burnout risk.
Florida TaxWatch recommends actions to scale what works and close gaps. First, expand community/home-based palliative care—models associated with higher satisfaction, more appropriate hospice use, and lower system costs. Second, establish a clear palliative-care regulatory framework that defines services and standards, provides predictable payment, and strengthens oversight. Third, better leverage the clinical workforce by granting APRNs appropriate autonomy in hospice/palliative settings to relieve bottlenecks and reduce costs. Fourth, fund Medicaid pilots to transition eligible patients into hospice earlier, improving sequencing across the continuum. Finally, retain hospice CON in statute to preserve Florida's high-quality, fraud-resistant network while continuing to refine regulation for access and accountability.
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