Category Archives: hospice costs

November is Hospice and Palliative Care Month

The theme for this year’s National Hospice and Palliative Care Month (which has just begun) is “Comfort. Love. Respect.” These three words are appropriate because they echo the philosophy of Hope Hospice.

“Comfort. Love. Respect.” Whether you view those three words as nouns or as verbs, they each reflect how we view our mission of patient care. We deliver comfort, love and respect to each Hope Hospice patient. We comfort our patients. We love our patients. And we respect our patients.

It’s important for the National Hospice and Palliative Care Organization (NHPCO) to designate November each year to increase awareness of hospice and the work being done around the US by hospice organizations. At Hope Hospice, we work with the same level of dedication 24/7/365, but we appreciate having a special month to recognize our efforts and tell the community what we do.

Among the key points being made this month by NHPCO are these:

  1. “Hospice is not brink-of-death care intended for the last days of life only.” That quote is from Dr. Donald Schumacher, president of NHPCO.
  2. Anyone can contact hospice. Call your local program to learn if hospice is right for you or your loved one.
  3. Hospice is fully covered by Medicare, Medicaid, and most private health plans and HMOs.

As hospice education continues and more families use the services of hospice, awareness of hospice is increasing. That’s good news. This fact may be even better news for families considering hospice: Research by NHPCO has found that 94 percent of families who had a loved one cared for by hospice rated the care as “very good” to “excellent.” We at Hope Hospice are proud to be part of a care group that is so highly rated.

“Comfort. Love. Respect.” Those are words we live by every day. During November, which is Hospice and Palliative Care Month, we share those words with our patients and families, our staff, our friends throughout the medical community and the general public.






Hospice Costs: The Rest of the Story

Legendary broadcaster Paul Harvey delivered a popular feature called “The Rest of the Story.” He would hook listeners with a catchy opening, provide some vague details and then reveal an often surprising ending. His concluding line was always: “And now you know… the rest of the story!”

How about this for an attention getting headline? “Government Spending More Than $12 Billion On Hospice Care.”

In 2011, ABC News reported that the amount Medicare pays hospice care organizations had increased 53% from 2005 to 2009. The main reason, says the report, is the number of patients using hospice also increased significantly.

The amount that Medicare paid hospices in 2009 was over $12 billion dollars, according to the ABC News report. That’s billion with a “B.” That’s a lot of money. That’s a figure that gets attention.

ABC News, to its credit, goes on in the report to explain what hospice care is, then quotes Robert Field, a health management professor from Drexel University in Philadelphia. He says that hospice care “is used more and more because it’s worked out for many people.”

The story also quotes the Don Schumacher, head of the National Hospice and Palliative Care Organization, who makes the excellent point that “hospice still saves the government money.”

The ABC report concluded with two telling quotes:

“For every patient admitted to hospice, it saves approximately $2,250 compared to patients with similar illnesses not admitted to hospice care,” said Schumacher.

“The fact that the government is spending more on hospice care might be a good thing,” said Field. “That could be money we’re not spending on long-term care or hospital care.”

Yes, Medicare spending on hospice care has increased because more people are using hospice. More people are using hospice because more people know about it and have been told about its benefits. Because more people are using hospice instead of spending time in hospitals, hospice is actually saving the government money!

And now you know…

….the rest of the story!




More On The Cost/Value Of Hospice

An amazing statistic appeared in a recent New York Times op-ed column. According to writer Susan Jacoby, “A third of the Medicare budget is now spent in the last year of life, and a third of that goes for care in the last month.” The column also states “the average hospital stay costs Medicare over $6,000 a day.”

Those are startling numbers. If you have recently filed taxes, you may have noted on your W-2 form the significant amount of your 2011 income that went directly to Medicare. (And that amount is not deductible.) Whatever the amount, you would probably have preferred to have that money in your own pocket.

Consider the amount of money that could be saved by Medicare (and we whose contributions fund it) if those who are dying in hospitals chose to die at home, under hospice care.

Another note regarding the massive hospital bills that are accumulated by those who prefer to die connected to tubes and monitors in a hospital: families are often obliged to pay some of the costs that are not covered by Medicare, including the tab for certain drugs. Whereas patients on hospice care are not obliged to make additional payments to the hospice agency.

How do you know if your loved one would prefer to spend his or her last weeks and months in the comfort of home? (As opposed to being in a hospital.) You ask. And you ask early in the dying process, when the patient still has a grip on reality.

These conversations can be difficult to get started. But once the topic is addressed, you may discover that your loved one has thoughts and desires that have never been voiced. And, like with many such dialogues we conduct in our lives, they often turn out to be much less uncomfortable than anticipated.

Hospice care is a money-saver for Medicare when compared to the cost of hospital in-patient care. Hospice care can also be a money-saver for families of patients whose hospitalization coverage is less than complete. But the main concern of families and health care providers should be patient comfort. That is always the top priority of Hope Hospice staff and administrators.

To learn more about hospice and all the elements of care provided, call Hope Hospice at 314-984-9800. Or click on

Our Top Priority: Patient Care

The medical industry has become, in recent decades, in many quarters, a numbers game. Hospital groups are buying out doctors’ groups for big money. Insurers and pharmacies are disagreeing on fair compensation. Consultants count the number of support personnel per doctor and suggest cutbacks if that number is too high.

Hospice care agencies, like other medical providers, have also been affected by this numbers game. At Hope Hospice, however, we make attentive patient care our top priority. Being an independent, privately owned hospice, we don’t answer to a corporate home office in a far away state. We are the home office. If a patient needs something that is beyond the norm, we don’t have to wait for days to get the answers. We walk right into the boss’s office and to ask for approval.

Similarly, we are not part of a hospital group. We are not required to make cutbacks in service due to shortfalls elsewhere in a regional system. We are a St. Louis based, independent agency.

Yes, we are also attentive to our budgets. We don’t scrimp in any way, but we do strive to work efficiently and effectively. In 2012, the costs of many things are increasing. Gasoline, food, pharmaceuticals, medical equipment, basic supplies are all going up. But we continue to provide several visits each week to each patient. We maintain a full staff that is on call 24/7.

Hospices are accustomed to fluctuations in patient counts. We adhere to practices that make our services to patients and families just as complete when we are serving a larger number of patients.

To work with hospice patients requires a special sensitivity and a special compassion. In some areas of medical care, a staffer may be able to disguise his or her level of concern, but in the world of hospice, it’s hard to do the work if you don’t possess those special qualities. We have had employees who came from other medical areas who learned quickly that they were not cut out for hospice work. We value our medical staff and provide fair compensation to keep them on board.

At Hope Hospice of St. Louis, we are dedicated to providing the best possible patient care and to providing strong support for the patient’s family members and caregivers. At the same time, we are concerned about finances, because that is what will allow us to continue to do the work to which we are committed.





The Value of Hospice Care

Here is an excerpt from the Wikipedia article on Hospice:

“Hospice is the only Medicare benefit that includes pharmaceuticals, medical equipment, twenty-four hour/seven day a week access to care and support for loved ones following a death.

Hospice care is also covered by Medicaid and most private insurance plans.”

This information is one of the most important elements of the hospice story. When a patient is referred to Hope Hospice of St. Louis, our representatives share details about the care we provide. After we list the many aspects of our patient care, the question is asked, “How much will this cost?”

Upon learning that the costs of hospice care are covered by Medicare/Medicaid/private insurance, there is frequently an audible sigh of relief from the patient and/or family members.

When you consider that hospice care includes much more than visits by nurses and home health aides, the value of hospice care becomes obvious. Addressing a patient’s emotional, spiritual and social needs, as well as physical/medical needs, allows hospice to play a huge role in a patient’s end-of-life process. The support and assistance offered to the patient’s family—before and after the patient’s death—also contribute to the value of hospice care.

Patients and families should take advantage of any hospice service that is offered. At Hope Hospice of St. Louis, we are proactive in making patients and families aware of all we can do. A conversation with one of our chaplains can be comforting. Advice from our social worker can help in dealing with a variety of issues. Our massage therapist can provide relief from pain and general stress relief.

Based on comments we regularly receive from families following a patient’s death, we are gratified to learn the real value of our work. We are frequently told that being able to spend those final weeks and months at home—with hospice care—made things easier for the patient. We hear about patient and family appreciation for our high levels of compassion and concern.

One of the greatest values of hospice care is the knowledge that, following the patient’s death, family members will not receive an invoice for services rendered. That can provide genuine peace of mind for all concerned.