an overview of hospice care - dhssdhss.delaware.gov/dhcc/files/de_hospice0612.pdf · an overview of...
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An Overview of Hospice Care
Presented by
Susan D. Lloyd, MSN, RN
President and CEO, Delaware Hospice, Inc.
Northeast Regional Director, National Hospice and Palliative Care Organization
(NHPCO)
Member, Public Policy Committee, NHPCO
Vice Chair, Hospice Action Network
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• Who What When Where & How’s of
Hospice
• Nationwide Snapshot of Hospice
• What Has Worked Well
• Advancing Healthcare that Cares
More & Costs Less
• Delaware Snapshot of Hospice
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• Who is hospice for?
• What is it?
• When is hospice appropriate?
• Where is care provided?
• How is hospice administered?
• Who pays for hospice care?
Who What When Where & How’s of Hospice
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Who is it for?
Patients who are facing a life-limiting illness.
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What is hospice?
• A model for quality, compassionate care
for people facing a life-limiting illness,
which helps patients and families live as
fully as possible, according to their
wishes.
• The focus is on caring, not curing.
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When is hospice appropriate?
When patient’s life expectancy is six
months or less and a decision is made
to opt out of the traditional care
delivery system.
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Where is care provided?
• In the home environment: private
residence, nursing home or
residential facility.
• Free-standing center or facility-
based (for higher levels of hospice
care).
• A Gallup poll indicates 9 out of 10
adults prefer to be in their own
homes at end-of-life.
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How is care administered?
• FOUR LEVELS OF CARE Routine Home Care (96% at this level)
Continuous Home Care
General Inpatient Care
Inpatient Respite Care
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How is care
administered?
• INTERDISCIPLINARY CARE TEAM
Physician, Registered Nurse, Certified Nursing Assistant, Social Worker, Spiritual Counselor, Bereavement Counselor and Volunteer.
Provides medical care, symptom management, emotional and spiritual support according to patient and family’s needs and preferences.
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How is care administered?
• FOCUS ON ENTIRE FAMILY
Support is provided to the patient and their caregivers.
Caregiver burden relieved through provision of medications and supplies, training on medical equipment, education about symptoms or future expectations.
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Who pays for hospice care?
• Payments on per diem basis include all
medications, equipment and supplies
• Medicare - largest payor since 1981
• Medicaid coverage since 1988
• Private Insurance – 83%
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Nationwide Snapshot (Source: NHPCO Facts and Figures for 2010)
• Est. 1.58 million patients received hospice services
• Average length of service: 67.4 days
• Majority in home environment: 66.7%
• Primary diagnosis:
Cancer 35.6%
Non-Cancer 64.4% (Heart, Debility, Dementia, Lung)
• Hospice providers in U.S.: 5,150
• Not-for-profit hospice providers: 36%;
For-profit hospice providers: 58%
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What has Worked Well
• Choice
• Coordinated Care Delivery
• Comfort of Home
• Inpatient Care
• Cost Effectiveness (Duke Study 2007)
• Caregiver Support
• High Levels of Patient/Family Satisfaction
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Advancing Health Care that
Cares More and Costs Less
• Expansion of service to variety of
diagnoses/settings. “Old” criteria
examined.
• Research on cost of hospice vs. traditional.
• Effective dialogue about end-of-life care
expenses.
• Mandatory Quality Reporting.
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Advancing Health Care that
Cares More and Costs Less
• EARLIER UTILIZATION OF HOSPICE MODEL IN CARE
CONTINUUM.
Concurrent care
Palliative care
PACE
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•INCLUSION IN THE ESSENTIAL
BENEFITS PACKAGE
Offering should mirror Medicare
Advancing Health Care that
Cares More and Costs Less
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Access to Hospice in Delaware
• DELAWARE HOSPICE
Established in 1982
Delaware’s only not-for-profit hospice
Serving the state from three offices
More than 3,000 patients/families
annually
Satisfaction: 98% of families served
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Access to Hospice in Delaware
TRANSITIONS
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Access to Hospice in Delaware
New Hope
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Access to Hospice in Delaware
Delaware
Hospice
Center
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Access to Hospice in Delaware
Family Support Services
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Jessica Harper’s Story
“Stopping treatment does not mean
giving up on life.”
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Delaware Hospice will provide the highest quality hospice
and health care services and serve as a trusted community
partner in end-of-life education and support.