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Pioneers in Rural Palliative Care

Since 2008, Stratis Health has pioneered processes for establishing and supporting palliative care services in smaller, rural communities. Recognizing that existing best practices were designed for large hospitals, Stratis Health led efforts to:

  • Determine palliative care models that work in rural communities
  • Establish measures to assess how rural palliative care delivers value
  • Support more than 26 rural communities to build community capacity to offer palliative care services
  • Develop a Rural Palliative Care Resource Center

Building Community-based palliative care

Stratis Health assists communities with program development and in building skills to improve advance care planning, symptom management, communication, coordination, and delivery of care to improve the quality of life and care for those with chronic diseases or life-limiting illness. Community-based teams identify their goals and resources, and then develop plans for implementation with a focus on current strengths and resources.

Stratis Health leads initiatives, acting as the convener and bringing expertise in rural health, quality improvement, and learning collaboratives. Our palliative care work has been in collaboration with Fairview Health Services' Palliative Care Program which has provided clinical and operational expertise in palliative care. UCare provides funded several initiatives.

Key findings related to developing, implementing and sustaining a rural, community-based palliative care program

Based on our experiences in rural palliative care, Stratis Health has found that:

  • Rural communities can provide palliative care services effectively and the models for service delivery can and do vary widely. Most of the programs participants developed are based out of home care organizations or are led by a nurse or nurse practitioner based in a clinic or hospital.
  • For most rural communities, external resources and support are necessary to support community development of palliative care services.
  • Ongoing networking for learning and sharing is critical to program sustainability and continuing progress.
  • Defining community-based metrics is essential to quantify the impact on cost, quality, readmissions, and patient and family satisfaction.
  • More widespread third party reimbursement for palliative care services, including visits by RNs, social workers, and chaplains, would make a significant contribution to the sustainability of programs in rural communities.
  • Development of palliative care programs and services must align with other efforts to redesign care delivery to maximize efficiency for rural providers. Changes underway due to implementation of the Affordable Care Act, and other health reform efforts offer unique opportunities for this type of alignment and collaboration.

More on our initiatives

New Stratis Health Project to Advance Palliative Care in Rural Communities. Project will expand access to services in three states and identify how to leverage alternative payment models and technology to foster rural palliative care. (November 2017)

Stratis Health Rural Palliative Care Impact Report, July 2016 (28-page PDF)

Palliative Care Fact Sheet. An overview of Stratis Health’s work. (2-page PDF)

Minnesota Rural Palliative Care Initiative: Building Palliative Care Capacity in Rural Minnesota, Journal of Palliative Medicine, February 2013, article abstract.

Palliative Care in Rural Minnesota: Findings from Stratis Health's Minnesota Rural Palliative Care Initiative, Minnesota Medicine, January/February 2016.

Rural palliative care resource center

Contact Stratis Health for assistance with your quality improvement and patient safety needs.

If your organization has projects it would like to work on, contact us to discuss how we can work together to support initiatives related to palliative care.


Janelle Shearer, program manager

Karla Weng, program manager