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Learn MoreWhat is Hospice?
The concept of hospice care is still a relatively new one in healthcare. Dr. Cicely Saunders began what is now the hospice movement fairly recently – in the 1960s – when she established what is believed to be the first hospice outside of London.
Hospice care is designed to provide supportive care to patients in the final stages of a terminal illness. Rather than focus on a cure, this type of care focuses on comfort and quality of life. Hospice care may be delivered in a hospital, a free-standing hospice or (most frequently) in a patient or caregivers home.
Hospice uses a multi-disciplinary approach that embraces the needs of both patients and family. The team may include physicians, nurses, social workers, clergy, dieticians, respite care providers and bereavement counselors.
In order to meet the criteria for hospice reimbursement, most insurers require that:
Hospice – The Four Stages of Care
Medicare-certified hospice providers must provide all four levels of hospice care.
Routine home care is the most basic of hospice services and may be delivered in the patient’s home or in a skilled nursing facility. While this is described as the most basic level, it actually includes a broad span of services from nurses, physicians, social services, home health aides, counseling, medications, medical equipment and supplies and lab services.
At this level of care a nurse and or an aide will remain in the home for 8-24 hours each day. Continuous care is a short-term option for the provision of hospice care and is re-evaluated every 24 hours. It is used for patients when their pain is not well controlled, they are experiencing severe nausea, vomiting or diarrhea, breathing difficulties or when there is a problem in the patient’s caregiver network that results in gaps or inadequacies in the patient’s care.
A patient who experiences sudden or short-term symptoms that are too difficult to manage at home may need this level of care. Symptoms such as those described in Level 2 above may also necessitate a move to inpatient care. Inpatient care means that nurses are available at all hours to provide medication, comfort and to closely monitor the patient’s condition.
This level of care may be provided in a variety of settings that include a free-standing hospice facility, a hospice unit in a regular acute care hospital or a hospice unit in a skilled nursing facility.
This level of care is essentially for the family. If the family is having a difficult time caring for the patient at home due to caregiver stress or other circumstances, a patient may be admitted to an inpatient unit to provide a break for caregivers. There is a five-day limit on this type of care. At the end of five days, the patient is typically discharged to home care.
Hospice – The Cost
Hospice costs like most healthcare costs in the US are largely invisible to patients, but there are significant costs associated with hospice care. Care that is provided on an inpatient basis can cost up to $10,000 per month depending on the level of care that is provided. Approximately 85% of the costs of end-of-life care are paid by government agencies with Medicare picking up the largest share (approximately 85%). Medicaid, private insurers, charities and self-pay are all in the single digits.
The healthcare delivery system, and how it is financed, has changed considerably since the 1960s when Dr. Saunders formalized the concept of hospice care and it has gotten substantially more expensive. The strides made in medicine have resulted in increased lifespans and while hospice patients spend a limited amount of time in hospice, the time that they do spend has increased in recent years. This along with an increase in the number of conditions treated in hospice has resulted in cost increases of up to $1 billion dollars per year.
Learn more about HealthStream workforce development solutions for hospice.
HealthStream’s learning management system and healthcare training solutions support medical training initiatives and allow for the best patient care.
View All Learning & PerformanceHealthStream offers performance learning management solutions to help develop your healthcare staff into leaders and reduce turnover.
View All ProductsHealthStream works with healthcare organizations to create engaging and high-quality training videos for your staff and management.
View All ProductsImprove care quality and save money by making informed decisions about your healthcare facility and staff with HealthStream's reporting analytics solution.
View All ProductsHealthStream's proven methods for the improvement and overall engagement of your healthcare staff foster a positive workplace and increase retention rates.
View All ProductsWhen you enact HealthStream's quality compliance solutions, you can do so with the confidence your healthcare organization will meet all standards of care.
View All Quality & ComplianceBe confident in your staff’s ability to reduce risk by providing compliance training that changes behavior.
View All ProductsDevelop next-level people for next-level care by prioritizing quality and safety improvements.
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View All ProductsUtilize patient access solutions and advanced reimbursement solutions to manage clinical denials and improve your organization’s reimbursement strategy.
View All ReimbursementExpand the decision-making skills and effectiveness of your healthcare workforce with HealthStream's clinical development programs and services.
View All Clinical DevelopmentLearn about our advanced resuscitation training solutions. Our solutions are designed to help improve patient outcomes.
View All ProductsOur competency development solutions personalize learning for clinicians to bridge the gap between theory and practice for your nurse residents.
View All ProductsEnhance maternal & child nursing care with solutions focused on improving the quality of care for mothers, infants, and children.
View All ProductsAddress staffing orientation challenges to easily achieve and maintain certification with our emergency and acute care training solutions.
View All ProductsAs a premier provider of healthcare education, we are committed to promoting safer, more successful surgical and sedation outcomes for each and every patient.
View All ProductsOur solutions are designed to cater to the needs of patients, healthcare professionals, and organizations dealing with illnesses or chronic conditions.
View All ProductsMake sure your healthcare staff can schedule out appointments and work schedules with ease using HealthStream's line of software solutions.
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View All CredentialingOur affordable CVO credentialing services establish patient safety by enabling primary source verification for your healthcare organization.
View All ProductsIntegrate with Epic to validate and add new providers directly to your provider master file.
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