There is a frequent misconception when it comes to palliative and hospice care. You’ve probably heard these terms used interchangeably. However, palliative care and hospice are not the same things. They have many similarities while there are also significant distinctions. Continue reading to learn more about the similarities and differences between palliative and hospice care. This blog will also help you to determine which is best for you or your loved ones.
What Is Hospice and Palliative Care?
Hospice care aims to enhance the overall quality of life and well-being of adults, children, and young people suffering from a terminal or long-term illness that cannot be treated, generally known as a life-limiting illness. It is free of charge for patients, caregivers, and family members. Both hospice and palliative care relieve the pain and symptoms of severe disease. They also treat patients and their families emotional, social, and spiritual needs. In truth, hospice is a sort of palliative care for those approaching the final stages of their lives.
The primary distinction between the two types of care is that treatment for severe disease is continued in palliative care. On the other hand, hospices only provide end-of-life care and discontinue treatments targeted at curing or treating the condition. This sort of treatment is also known as palliative care, and it can be administered in a hospital, at home, or in a community setting.
Similarities Between Palliative and Hospice Care
Both palliative and hospice care seek to alleviate discomfort and pain while honouring a person’s values, supporting the family, and providing individualized care. Palliative care is concerned with providing comfort and compassion and managing symptoms. To “palliate” is to “relieve.” When you have pain under control, you can concentrate on what is essential to you. Palliative and hospice care are both medical specialties that assist people of all ages suffering from severe, long-term illnesses such as, but not limited to, those listed below:
- Cancer
- COPD (chronic obstructive pulmonary disease)
- Heart failure
- Kidney disorder
- Failure of an organ
- Parkinson’s disease (PD)
The main goal of both palliative and hospice care are as follows:
- Improve the quality of life and comfort
- Focus on providing emotional support and assist you in making critical medical treatment decisions
- Palliative and hospice care collaborate with your primary care physician to supervise and coordinate your care.
- Both provide medications to help alleviate pain and other bothersome symptoms.
- They provide access to chaplains, social workers, and other experts to help coordinate care in addition to medical care.
Palliative Care Vs Hospice Care
Knowing the differences between hospice and palliative care might help people decide which level of care is appropriate. If your health changes, the type of care you receive may vary.
Palliative care | Hospice care | |
| What is the main focus? | Palliative care focuses on relieving pain and discomfort, lowering stress, and assisting individuals in living their best lives possible. | When a cure is no longer possible, or the costs of therapy exceed the benefits, hospice care concentrates on the quality of life. |
| Who is eligible for this type of care? | Anyone suffering from a severe disease can benefit from palliative care. | If their doctor believes they have less than six months to live, they can be enrolled in hospice Medicare coverage. If a physician certifies, the benefit may be extended numerous times. Hospice services are also available to people who have Medicaid or private insurance. |
| Where can I get this kind of treatment? | Palliative care can be delivered in various settings, including the home, hospital, nursing homes, and outpatient clinics. | Hospice care is available wherever the patient resides, including nursing homes and long-term care institutions. |
| Who is responsible for this type of care? | A specially trained team of doctors, nurses, and other specialists provides most palliative care. They will collaborate with your primary care physician and specialists. | A team that focuses on the patient’s needs provides hospice care. Clergy, home health aides, hospice physicians, nurses, social workers, trained volunteers, and other specialized therapists are usually part of the team. Hospice provides a lot of assistance, and the inner circle or paid home health aides provide the day-to-day care if the patient lives at home. |
| Who is responsible for paying for this type of care? | The medical aspects of palliative care are covered by Medicare, Medicaid, and many insurance plans. Veterans may be eligible for VA-provided palliative care. | Medicare frequently covers hospice care as a benefit. Hospice care may also be covered by Medicare Advantage plans, state Medicaid plans, or private insurance. |
| How long will patients be able to receive this type of care? | Palliative care can be provided for as long as necessary. Discuss with your doctor what level of care is best for you as your health changes. | Hospice care can be started and continued if your doctor believes you have less than six months to live. When people receiving hospice care live for more than six months, their care can be extended. Hospice care is available for an unlimited number of 60-day benefit periods and two 90-day benefit periods. |
Palliative Vs Hospice coverage
Organizations provide several variations of palliative care across the country. Physician practices and hospice organizations are attempting to develop an official model that is not only financially viable but also effectively provides to patient populations who require these services the most. Until then, providers should be aware of current palliative care billing guidelines.
Billable Palliative Care Services
The most common payer for palliative professional services is Medicare Part B. MAOs are needed to offer the same services as original Medicare, so they also provide these services to registrants as the benefit of a professional service. Private insurance and Medicaid may also cover palliative provider professional services, but authorization to bill for consulting provider services may be required.
Non-Billable Palliative Care Services
Many hospice and home health organizations offer non-billable palliative care services, such as hospice care, with the participation of a multidisciplinary team that includes nurses, chaplains, and social workers. While this service may occasionally be billed under the Medicare home health benefit, it is not billable as palliative care under conventional Medicare professional services.
Hospice coverage
Hospice care and assistance is a thorough, all-encompassing programme for terminally ill patients and their families. Hospice care shifts the emphasis from curative care to supportive care (palliative care) for pain relief and symptom management. Hospice billing is one of the most common concerns because it requires time-consuming data entry, paperwork, and never-ending communications and follow-up to ensure your claims are paid. Avoid misunderstandings and clarify hospice billing guidelines to make final services less challenging.
Their responding physician (if they have one) and the hospice physician certify that they are terminally ill, with a medical prognosis of 6 months less than to live if the illness usually progresses. They signed an agreement electing the hospice benefit and delaying all rights to Medicare payments for terminal illness and associated illnesses.
Following certification, the patient may choose the hospice benefit for:
- Two 90-day periods are followed by an infinite number of 60-day periods.
- Following the second 90-day period, the recertification affiliated with a hospice patient’s third benefit period and any subsequent recertification must include the paperwork that a hospice nurse practitioner or a hospice doctor had a face-to-face encounter with the patient.
Patients with Medicare Part A may be eligible for hospice care if they meet the following criteria:
- The FTF encounter must include documentation of clinical findings that support a life span of six months or less.
- All hospice billing services provided to patients and their families must adhere to an individualized written plan of care (POC) tailored to the patient’s particular needs. The POC is established by the hospice interdisciplinary group in collaboration with the attending physician (if any), the patient or representative, and the primary caregiver.
- They receive hospice care from a Medicare-certified hospice.
Final Thoughts
Palliative and hospice care assist patients in shifting goals and achieving new priorities, whether to remain at home, spend quality time with family and friends, participate in favourite activities or hobbies, or attend important events or accomplishments. Patients receiving palliative or hospice care, instead of “giving up”, concentrate on what is most crucial to them and creating every moment counts.
