Q: My mother has had home health services with her diabetes. Now she has been diagnosed with cancer, and her doctor is recommending hospice. What is the difference between hospice and home health?
A: Home health is for patients whose conditions are expected to improve. Hospice cares for those with serious illnesses whose health is declining. Home health is designed to help a homebound patient reach a certain level of improvement. For example, a diabetes patient like your mother might need help learning to manage her insulin levels by herself. As she becomes more independent, the number of home health visits would decrease until she is discharged. Hospice, entering the scene of a more serious disease like cancer, is designed to increase the number of visits as the patient's condition worsens.
Just as the missions of home health and hospice organizations differ, there are significant operational differences as well. Home health focuses its attentions on the patient. By contrast, hospice is not only focused on the patient's needs, but also supports and educates the patient's family caregivers.
The two entities are also paid for differently. Medicare, Medicaid, Workers' Compensation, and private health plans all have home health benefits, but they are limited to the duration of the patient's recovery or improvement to a certain level. These benefits cover a portion of the expenses. For example, only 80% of the cost of durable medical equipment (DME) is covered, and medications are the individual's responsibility.
Hospice patients also receive Medicare, Medicaid and insurance benefits, but they are more inclusive. These benefits would pay for the entire cost of the DME and medications related to the patient's illness. About 95% of hospice patients are covered by Medicare, Medicaid or insurance. However, if you are in the remaining 5%, don't despair: few hospices will turn away a patient for an inability to pay. If you are concerned about payment issues, ask the hospice admissions professional about your options. Many hospices, including mine, maintain specially donated funds for the care of patients without other resources.
If you are concerned about a loved one, please send your questions to asklinda@pchcv.org. See you next week!
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