Hospice Care in The United States - Providers

Providers

Hospice is a competitive business. In any given service area, there may be hundreds of different non-profit and commercial providers. Hospices can be small community-based operations, part of regional and national corporations, or part of a hospital or other health system. Data from the National Hospice and Palliative Care Organization indicated that in 2008 58.3% of hospice agencies were independent, with 20.8% based in hospitals, 19.7% geared for home health care and 1.3% in conjunction with nursing homes. In 2007, the mean number of patients being treated in hospice facilities on any given day was 90.2. 79.4% of hospice providers admitted fewer than 500 patients per year. The number of for-profit and non-profit providers has become more balanced as the for-profit sector has grown. In 2007, 47.1% of agencies were for-profit, with 48.6% non-profit. The remaining 4.3% were government-owned providers.

In order to receive payments for hospice patients under Medicare or Medicaid, a hospice must be certified by the Centers for Medicare and Medicaid Services, and in 2007 93.1% were. Among those that were not certified, some were in the process of seeking certification. However, some agencies do not seek certification or voluntarily relinquish it. For one example, an agency that is entirely supported through donations or relies on volunteer staff might not choose to seek certification. The NHPCO estimated in 2008 that at least 200 "all-volunteer" programs were in operation in the United States.