An Examination of the Relationship of Reimbursement and Organizational Structure to the Use of Hospice Volunteers

This article examines the use of volunteers in hospice based on a national study of hospice programs. The data collected as part of the study make it possible to address several questions related to the prevalence and role of volunteers. Does the prevalence of volunteers decrease with the availability of reimbursement for hospice services? Is reimbursement related to a shift in the types of activities performed by volunteers? Is the level of volunteer involvement and the mix of volunteer activities related to type of hospice organization? Although it was hypothesized that volunteer activities would shift to non-patient-related tasks with the availability of reimbursement, this was not found to be the case. The availability of Medicare reimbursement for hospice services was not related to a decrease in the ratio of volunteers to paid staff. Freestanding hospices utilized volunteers to a greater degree than institution-affiliated hospices.