Development of Hospice:

1967 -- Dr. Dame Cicely  Saunders established the first modern hospice, St. Christopher's Hospice outside of London.

1974 -- the first hospice in the United States, The Connecticut Hospice, Inc., began to provide hospice services.

1979 -- HCFA initiated demonstration programs at 26 hospices across U.S..

1982 -- Congress created a Medicare hospice benefit.

1986 -- Congress made the Medicare hospice benefit permanent. 

1989 -- Congress mandated to increase Medicare hospice reimbursement rates by 20%.

In 1984 there were just 31 hospices participated Medicare program, in 1995 increased to 1,857, and in 1998 increased to 2,287.  Of these hospices, 890 are freestanding, 811 are home health agency-based, 564 are hospital based, and 22 are skilled nursing facility based.  In 1998 and 1999, around 1% of total Medicare spending, or $2 billion spent on hospice care.  In 1998 the Medicare hospices served around 540,000 patients.