How Are Hospice Services Paid For?

 

How are hospice services paid for? This question seems like it should have a very concise answer; but in reality, it is so complex.  Like many hospices, Hospice of the Red River Valley is Medicare-certified. We are also licensed in both Minnesota and North Dakota, which means we are regulated by federal and two state laws.

For patients who have Medicare Part A, hospice is reimbursed at a per diem (daily) rate that is determined by where the patient resides. These rates for each of the four levels of care are regulated by Medicare and paid for through the Medicare Hospice Benefit. The four levels of care are routine home care, continuous (concentrated) home care, general inpatient and inpatient respite. Medicare has regulations that determine the level of care required. Medicare-certified hospices accept the Medicare payment and there is no charge to the patient.

Private insurance companies generally follow the Medicare guidelines and reimburse at per diem rates also. The dollar amount per day varies per insurance plan. We work with each insurance company individually to determine what services we may provide and what their reimbursement will be.  Each insurance plan has a co-insurance and a deductible that is the patient’s responsibility.

Medicaid (medical assistance) in both Minnesota and North Dakota follow the Medicare guidelines and per diem reimbursement for the four levels of care, and there is no charge to the patient. The Veteran’s Administration also allows for per diem hospice services.

At Hospice of the Red River Valley, patients who have no insurance coverage are provided the same services as the per diem arrangements. We are required to send a statement to the patient, and they may pay what ever amount they are able to pay. Thus, hospice relies on gifts and donations to cover services and costs that have no reimbursement.

Additional Information
MN Network of Hospice & Palliative Care: Who Pays for Hospice Care?http://mnhpc.org/public/about-hospice-care/getting-started-with-hospice-care/who-pays-for-hospice-care
Medicare Hospice Benefit: http://www.medicare.gov/publications/Pubs/pdf/02154.pdf

About Hospice of the Red River Valley
Hospice of the Red River Valley is an independent, not-for-profit hospice serving all, or portions of, 29 counties in North Dakota and Minnesota. Hospice care is intensive comfort care that alleviates pain and suffering, enhancing the quality of life for patients with life-limiting illnesses and their loved ones by addressing their medical, emotional, spiritual and grief needs. For more information, call toll free 800-237-4629, email questions@hrrv.org or visit www.hrrv.org.