The number of clients a hospice agency can serve a year will more or less depend on the capabilities of the agency. In the United States, there is no caveat on the number of clients a hospice agency can attend to annually. Hospice agencies are most often reimbursed a daily rate for each patient, regardless of the level of services they provide that day.

In the United States, payment amounts vary each year, however, the average for routine care is approximately $146/day. If continuous care is required, Medicare reimburses at an hourly rate of approximately $40/hour. The demand for hospice care is increasing, and hospice providers in a highly competitive marketplace are striving to bring in as many patients under their wings as they can carry.

Hospice care in the United States is inherently collaborative. Patients tend to get proper care, not from a single clinician but an interdisciplinary team. Have it in mind that growing the scope of collaboration involves referring organizations like hospitals, long-term care, and highly skilled nursing facilities that can help increase referrals and support quality patient care.

The care is exclusively reserved for terminally ill patients and entails a life expectancy of 6 months or less. However, note that if an individual goes on to live beyond the stipulated term, the concerned doctor will be expected to recertify that the disease borne by the patient is incurable.

Families who are looking to extend palliative care to their members are without doubt the primary clients in the hospice business. Entrepreneurs looking to venture into this business are expected to establish a complete center for care and employ a compassionate nursing staff.

Losing someone you cherish is tough, and the government makes it easy so that people don’t have to bother about looking for ways to finance their loved one’s hospice care, especially with care costing being as high as $160 per day, and quickly reaching $30,000 for the whole six-month period.

How Much Do Hospice Agencies Get Per Client?

Coupled with the clinical aspects of care, a hospice agency reaches out to patients and families during their most challenging moments. However, note that how much these agencies get per client will vary based on numerous factors. These factors include;

In recent times, hospice agencies in the United States reported median revenue of $6,865 per patient and $138 per patient–day (for-profit-not-for profit [FP-NFP] difference −$20, p = 0.045), median cost of $6,737 per patient, and $135 per patient–day (FP-NFP difference −$55, p = 0.002), and median pretax profit of $334 per patient and $6 per patient–day (FP-NFP difference $34, p = 0.026).

According to industry reports, patients tend to most often get an average of 29.9 total visits by all providers per patient (FP-NFP difference 8.8 visits, p = 0.010), however, there was no notable difference in total visits per patient–day.

Reports have it that an average of 50.8% of all nursing visits were registered nurse (RN) visits (FP-NFP difference −14.1%, p < 0.001). Howbeit, only very few hospices offered charity care, and only 4% of hospices noted expenditures on chemotherapy and only 9% on radiation therapy.

  • The Hospice Team

Most often, a multifaceted health care team caters to the needs of a hospice patient. This entails that there are numerous health care professionals involved in helping to manage the patient’s care, based on each patient’s needs and preferences.

However, the more the team involved in the care, the more money the agency can charge for the services they offer. In most cases, the hospice doctor or medical director is in charge of the patient’s care, though there may also be a cancer doctor and/or primary care doctor too.

Doctors, nurses, social workers, counselors, dietitians, home health aides, clergy, therapists, and trained volunteers can also all contribute to helping the patient and primary caregiver make decisions about the care that’s required. Also note there will be regular reports, as well as family and care team meetings to analyze the patient’s status to validate that all the patient’s needs are being addressed. 

  • Where The Hospice Care Is Provided

In the United States, hospice agencies most often provide services in the patient’s home. However, also note that hospice care can also be offered by free-standing or independent facilities primarily built and designed to offer hospice care, or via programs based in hospitals, nursing homes, assisted living centers, or other health care systems.

There are also hospice agencies that make available both care in the home and care in an inpatient facility. Note that the location where the care is provided will influence how much the agency gets for each client they cater to. 

  • Who is Paying for the Hospice Care 

In the United States, Medicare, Medicaid, and insurance policies are known to cover hospice care. Veterans may also be eligible for this sort of care through the Department of Veterans Affairs. There are also private health insurances that pay for some services. Hospice costs are paid for in the following manner: Medicare – 85.4%; Medicaid – 5%; managed care or private insurance – 6.9%; others (including charity and self-pay) – 2.7%.

However, for people who are not insured, or who may not have adequate coverage for hospice services, there are hospice organizations that offer care at no cost or at a subsidized rate based on the client’s ability to pay. These agencies can often do this due to donations, grants, or other sources.

  • Hospice Agency Expenses 

Hospices agencies are known to spend more money at the beginning and the end of a patient’s care, and they more or less profit most in the days when a care routine has been established. Have it in mind that this has led to some hospices admitting patients who are healthier to ensure that the agency incurs fewer expenses while still receiving the $160 per day of the patient’s stay.

They most often do this to boost profits instead of considering patients’ eligibility and end-of-life comfort. Such practices are steadily being investigated by the Medicare Payment Advisory Commission (MedPAC) since they result in little or no slots for patients who need hospice care.

  • Length of Stay 

Have it in mind that length of stay is strongly associated with financial performance, and how much the hospice agency gets per patient. Most patients do not enroll in hospice until their time of death draws near. Reports have it that almost half of the patients who enrolled in hospice died within three weeks, while 35.7 percent died within one week.

Howbeit, note that a good number of patients survive for six months or more, with 12 to 15 percent of patients falling into this category. While it can be quite difficult to foretell how long someone will live because each case varies, patients who were younger than 65 when they were enrolled tend to be less likely to die within six months.

The maximum length of eligibility for hospice care is six months, and so patients are not expected to live beyond six months at the time of their admission. But according to industry reports, a good percentage of patients end up surviving past the six months time frame, and might even be eligible for further hospice, or they may be discharged.