Hospice & palliative care

Choosing a Hospice in the Boston, MA Area

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Greater Boston has one of the densest concentrations of hospitals and academic medical centers in the country, which shapes how families here get referred to hospice — often straight from an inpatient discharge planner rather than a slower outpatient path. That makes it easy to sign whichever agency the hospital suggests. This guide covers reading the public data yourself, plus what's specific to Massachusetts and the Boston-area counties, before you sign anything.

Last updated: July 2026

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How to Compare Hospices Serving Greater Boston

Medicare's Care Compare tool is the starting point: search by zip code across the Boston area and you'll get a list of Medicare-certified hospices, each with its CAHPS Hospice Survey scores and other quality measures made public through CMS's Hospice Quality Reporting Program 1. The tool itself is built for exactly this kind of comparison 2; it won't rank agencies for you, but it puts the same measures side by side so you can.

Three numbers are worth more of your attention than the rest: how caregivers rated communication and symptom management on the CAHPS Hospice Survey 3, whether the hospice is for-profit or not-for-profit, and its live-discharge rate — how often patients leave hospice alive, sometimes because their needs outgrew what the agency could deliver. A separate guide on judging hospice quality walks through all three in depth; here, the job is applying them to the agencies that actually cover your zip code.

Massachusetts Licenses Hospices Separately From Medicare Certification

Medicare certification is not the only oversight a Massachusetts hospice answers to. The state's Department of Public Health licenses and inspects hospice programs under its own health care facility rules, separate from the federal survey that determines Medicare certification. That gives Massachusetts families a second, state-level channel — a formal complaint about a licensed hospice can go to the Department of Public Health, not only through Medicare's own process.

This matters practically: a hospice can look fine on Care Compare and still have an open state licensing complaint, or the reverse, because the two systems review different things on different schedules. Asking a hospice directly whether it has had a recent state licensing survey, and what came of it, is a fair question — and one Massachusetts's dual oversight structure makes worth asking here.

Why Greater Boston's Hospital Density Changes the Referral Path

In much of the country, a family researches hospice on their own time, weeks before they need it. In Greater Boston, with its unusually high concentration of academic medical centers and hospital systems, the more common path is a referral handed over during a hospital discharge — often with a single name suggested by a case manager who works closely with one or two agencies.

That default suggestion may be a fine choice, but it is a suggestion, not a requirement. Patients have the right to choose their hospice from among those serving the area, and a discharge planner's short list is rarely the full list Care Compare shows for your zip codes. If a hospital case manager hands you one name, it is reasonable to ask for a day or two to check that agency's CAHPS Hospice Survey scores and live-discharge rate against its competitors before signing intake paperwork.

MassHealth and Hospice: What Changes If You're Dually Eligible

Massachusetts's Medicaid program, MassHealth, runs its own hospice benefit that closely follows Medicare's, and the two coordinate for people who qualify for both. The difference that matters most shows up in a nursing facility: for a dually eligible resident, Medicaid can pay a room-and-board rate that passes through the hospice, covering a cost the Medicare hospice benefit does not 4. Exactly how this is billed varies by state, so it is worth confirming the specifics with MassHealth and the hospice's admissions office rather than assuming 4.

For someone cared for at home, room and board is not a factor, and MassHealth hospice coverage functions much like the Medicare version: comfort-focused care, an interdisciplinary team, and no deductible for the hospice benefit itself.

Comparing Agencies Across Suffolk, Middlesex, and Norfolk Counties

A single hospice's service area in Greater Boston often spans several counties rather than sitting inside city limits, so filtering Care Compare by one narrow zip code can miss agencies that would still drive to your home. Before ruling an agency out for distance, check its full service area — most will state it plainly over the phone — since a hospice based in one county routinely covers patients across Suffolk, Middlesex, Norfolk, and parts of Essex.

That wide service radius cuts both ways: more agencies are realistically available to a given address than a zip-code-only search suggests, but the closest-sounding name is not always the one that reaches your specific street. Ask directly whether your address falls inside routine coverage or requires special arrangement for after-hours visits.

Ownership Type Predicts Real Differences in Family-Reported Care

For-profit and not-for-profit hospices are not interchangeable labels. Family caregivers nationally report worse experiences across every domain of the CAHPS Hospice Survey at for-profit agencies, including communication, symptom management, and willingness to recommend 5. Live discharge follows a similar pattern: burdensome transitions after a live discharge — rehospitalization or dying in a hospital rather than at home — are more likely at for-profit hospices and after short stays 6.

None of this means a for-profit hospice serving Boston is automatically the wrong choice, or that every not-for-profit is excellent; both kinds appear on Care Compare's list, and the specific agency's own CAHPS scores matter more than the ownership label alone. But ownership is public information on Care Compare, and it is one more data point worth checking before it becomes one more thing you wish you had asked.

Questions Worth Asking Before You Sign

A hospice's answers to a short set of direct questions tell you more than its brochure will. Worth asking before intake: who is on call overnight and how quickly they typically reach a home in your specific town, what happens if pain or breathlessness becomes hard to control, and how the hospice handles a transfer to general inpatient care if symptoms can't be managed at home.

Also ask what happens if your loved one no longer qualifies for hospice, or improves and wants to stop — a well-run hospice can explain live discharge and re-enrollment clearly, without hesitation. If an agency is vague about any of these, treat that vagueness itself as information.

Common questions

No. Hospitals in Greater Boston work closely with agencies they refer to often, but patients have the right to choose from any Medicare-certified hospice serving their address. Care Compare, filtered to your zip code, shows the fuller list. It's reasonable to ask a discharge planner for a day to compare before signing paperwork with the suggested agency.

Massachusetts hospices are licensed by the state's Department of Public Health, separately from Medicare certification. A complaint about care can go to the Department of Public Health as well as through Medicare's own complaint process. Ask the hospice directly for its complaint procedure, which every Medicare-certified agency is required to have in writing.

Largely, yes. MassHealth runs a hospice benefit that mirrors Medicare's comfort-focused coverage for people who qualify for Medicaid alone, and coordinates with Medicare for those who have both. Its most useful extra applies in a nursing facility, where MassHealth can help cover room and board, a cost Medicare's hospice benefit does not pay.

Ask directly, rather than assuming from the name or address. Many hospices serving Greater Boston cover a wide, multi-county area that a single zip-code search on Care Compare won't fully capture. A hospice can confirm by phone whether your specific address falls in routine coverage, and what after-hours visits look like there.

Not automatically. Nationally, for-profit hospices score lower on average across CAHPS Hospice family-experience measures and have higher rates of burdensome live discharge, but individual agencies vary. Check the specific hospice's own CAHPS scores and live-discharge rate on Care Compare rather than ruling it out on ownership type alone.

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When Choosing Can't Wait

  • —Pain, breathlessness, or agitation that is not controlled while you are still comparing agencies
  • —A hospital discharge is happening within a day or two and no hospice has been chosen yet
  • —The person's condition is changing rapidly and researching further feels unsafe to delay

If symptoms are severe and no hospice team is in place yet, call the current treating physician or go to the nearest emergency room rather than waiting to finish comparing agencies.

This article explains how to evaluate hospice agencies using public data; it is not medical advice and does not recommend a specific hospice. Licensing rules and Medicaid coverage details change and vary by circumstance — confirm current specifics with the Massachusetts Department of Public Health, MassHealth, and any hospice you are considering.

References

  1. 1.Centers for Medicare & Medicaid Services (2024). Hospice Quality Reporting Program. Centers for Medicare & Medicaid Services (CMS). link ✓Supports that CMS runs a formal Hospice Quality Reporting Program that feeds the public measures shown on Care Compare.
  2. 2.Centers for Medicare & Medicaid Services (2024). Find Healthcare Providers: Compare Care Near You (Hospice). Medicare.gov / Care Compare (CMS). link ✓Supports using Care Compare to search and compare Medicare-certified hospices by location.
  3. 3.Centers for Medicare & Medicaid Services (2024). CAHPS Hospice Survey. Centers for Medicare & Medicaid Services (CMS). link ✓Supports what the CAHPS Hospice Survey measures, including caregiver-reported communication and symptom management.
  4. 4.Centers for Medicare & Medicaid Services (2024). Hospice Payments (Medicaid). Medicaid.gov (CMS). linkSupports that Medicaid (MassHealth) can pay a room-and-board rate for a dually eligible nursing-facility resident on hospice, passed through the hospice, with rules that vary by state.
  5. 5.Anhang Price R, Parast L, Elliott MN, et al. (2023). Association of Hospice Profit Status With Family Caregivers' Reported Care Experiences. JAMA Internal Medicine. doi:10.1001/jamainternmed.2022.7076 ✓Supports that family caregivers report worse experiences across CAHPS Hospice domains at for-profit hospices compared with not-for-profit hospices.
  6. 6.Peer-reviewed cohort study (see article) (2024). Hospice Readmission, Hospitalization, and Hospital Death Among Patients Discharged Alive from Hospice. JAMA Network Open (PMC11099680). PMID 38753329 ✓Supports that burdensome transitions after a live discharge from hospice are more likely at for-profit hospices and after short stays.

6 sources, numbered by first appearance. General health information, not medical advice. AI-assisted editorial content — citations link their sources. Editorial policy

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