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Hospice Care Overview

A Misunderstood, Reimbursable and Vital Service


Each of us has the right to die pain-free and with dignity, and that our loved ones will receive the necessary support to allow us to do so. That is the belief of the National Hospice and Palliative Care Organization and is reflected in the work that hospice providers do around the country. Yet hospice is very misunderstood. Let’s start clearing this up.

1. Hospice Basics

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Hospice and palliative care involve a team-oriented approach to expert medical care, pain management, and emotional and spiritual support expressly tailored to the person’s needs and wishes.

Hospice focuses on caring, not curing and, in most cases; care is provided in the person’s home. It can also be provided in freestanding hospice centers, hospitals, and nursing homes and other long-term care facilities.

Hospice services are available to patients of any age, religion, race, or illness and services are covered under Medicare, Medicaid, most private insurance plans, HMOs, and other managed care organizations.

2. Hospice Care Team

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The hospice care team is obviously an integral part of a person’s care that assure that the there is a true quality of life at the end of life. The team usually consists of:

  • Clergy or other counselors
  • Home health aides
  • Hospice physician (or medical director
  • Nurses
  • Social workers
  • Trained volunteers
  • Speech, physical, and occupational therapists, if needed
  • The person's personal physician may also be included.

Most often, a person can choose to have their personal doctor involved in the medical care. Both the physician and the hospice medical director may work together to coordinate the person's medical care, especially when symptoms are difficult to manage.

In many cases, family members or loved ones are the person's primary care givers. Hospice staff must recognize their own special needs for support. As a relationship with the hospice begins, hospice staff will want to know how best to support the person and family during this time.

Educating the public about this misunderstood service is key. And through that education, you can build relationships that in the future can turn into referrals for your service. So actively engage the staff in the community and reap the rewards.

3. Hospice Reimbursement

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The arena of hospice care reimbursement is often misunderstood by the public and in fact a perception that it is not a covered service often makes caregivers shy away from seeking hospice services. This is what your potential clients should understand.

Hospice is paid for through the Medicare Hospice Benefit, Medicaid Hospice Benefit, and most private insurers. If a person does not have coverage through Medicare, Medicaid or a private insurance company, hospice will work with the person and their family to ensure needed services can be provided.

Medicare defines a set of hospice core services, which means that hospices are required to provide these set of services to each person they serve, regardless of the persons insurance.

The Medicare Hospice Benefit does not cover treatment intended to cure an illness though patients can receive comfort care to help manage symptoms related to their illness.

Medicare is not the only source of reimbursement for hospice services. Commercial Insurance may include hospice coverage. Managed care insurance companies identify their "network" and patients have to select a hospice within that network to receive coverage. Elderly nursing home residents on Medical Assistance may continue to receive the room and board coverage from Medical Assistance, while receiving hospice care.

U.S. Veteran's Benefits includes provisions for hospice care. And Long-term Care Insurance may reimburse some services not covered by Medicare.

Educate your community on the vast amount of covered hospice services so that they will be more receptive to considering this type of care for a loved one.

4. Hospice Facts and Stats

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The hospice marketplace is growing as more people become educated about it and the type of patient benefiting has diversified too. Here are some statistics to ponder.

5. The Integration of Hospice and Palliative Care

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The hospital industry is paying more attention to hospice and palliative care. As you start to make the business case for hospice and palliative care and as you see the healthcare model shift from fee for service and sickness to bundled payments and wellness, it becomes clear that these services play into the new model while fulfilling many of the Aims of Quality from the Institute of Medicine.
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