The spirit of service has been there from the very beginning. Started by volunteers in 1978, Hosparus Health has grown into a not-for-profit organization that’s helped thousands of families in Kentucky and Southern Indiana cope with life-limiting health issues. And along the way, it’s developed a credo stemming from its core mission: no one is turned away.
“We love and serve our community, and want to care for them the best we can,” says Lauren Wilson, senior director of reimbursement and health information management at Hosparus. “We raise funds to support our charity program. We’ll help people seek alternate funding sources. We really do our best to find a solution that's going to be financially viable, so ultimately, our patients and families get the care they need and deserve.”
Hospice care, which is for people who are expected to live 6 months or less, helps patients and families get so much more out of the final stages of life. But this type of supportive care also faces many misconceptions. One of them is financial. People see the red tape and high costs so often associated with managing complex health issues and assume an organization like Hosparus Health is just the same. The reality, though, is far different — most Hosparus patients pay little if anything at all, no matter if they’re using Medicare or private insurance.
“Sometimes, there’s just a barrier when it comes to understanding what hospice care really is,” Wilson says. “We’re here to help them through their journey, to live the best life they can for as long as they can. And there’s also a lack of awareness when it comes to the financial component — people often expect they may have a large out-of-pocket expense, or perhaps that Medicare coverage or commercial insurance coverage would not pay for it. That’s simply not the case.”
100 percent coverage
Medicare covers 100 percent of hospice care once a physician certifies that a patient has six months or less to live. The coverage not only includes care from doctors and nurses, but also medicines needed for pain or symptom management, necessary medical equipment such as wheelchairs or walkers, potential inpatient care for symptom management, respite care for family caregivers, grief and loss counseling, as well as any other services as determined by a patient’s hospice team.
“We take a look at the patient's plan holistically,” Wilson says. “We pay for medications; we pay for any type of durable medical equipment that is appropriate and necessary, and any type of therapies the patient may need. We provide bereavement service, both to help prepare for death and to support family and friends for up to 13 months after the patient passes. And when we say ‘family,’ it doesn’t have to be blood family — it’s for anyone involved in the patient’s care who’s grieving and feeling a loss for that particular patient.”
It’s all part of Hosparus Health’s team approach that includes doctors, nurses, CNAs, social workers, chaplains, grief counselors and volunteers. Most private insurance plans also cover hospice at or near 100 percent, with the possible exception of a minor copay for prescription drugs. And as a nonprofit, Hosparus has a financial assistance program to help those who may be underinsured.
“The instances where patients have an out-of-pocket expense are somewhat rare,” Wilson says. “It depends on their plan, and there are a lot of variables. But if I had to estimate, I’d say about 95 percent of patients never see any sort of bill for our services.”
Hosparus Health also offers palliative care, which is for people with serious but non-terminal conditions. Palliative care is covered differently than hospice. Because it often involves healthcare practitioners seeing the patients in their homes, it is typically reimbursed by insurance similar to a doctor visit. Hosparus officials are working through legislative channels to expand coverage for palliative care.
One less worry
The care teams at Hosparus see it time and time again — patients or family members who once believed hospice care was an expensive service only for the final days of life discover that they and their loved ones can get so much more out of their final months or even years. And the earlier Hosparus Health is involved, the more they can help with symptom management so patients and families can make more moments together.
“I was really shocked when I first joined the organization. I was wearing one of my logo shirts, and it was just incredible how many people recognized Hosparus and stopped me and said, ‘I can't believe the excellent care that you provided to my family member,’” Wilson says. “It makes me feel really proud of who we are and what we do for people.”
Those revelations can extend to the financial aspect of hospice care as well — which, because it’s covered at or near 100 percent, removes one less worry for patients and families with plenty on their minds already. They know that, at Hosparus, no one is turned away.
“There’s a lot for a family to comprehend and understand in that moment and time,” Wilson says. “There's a lot of information from hospitals and physicians, depending on where the patient is in their journey. And we are different from other providers in the sense that primarily, we are covered at 100 percent in the majority of cases. So, I think because of people's experiences with other healthcare providers, they just expect that it's something that they can't afford or comes with some financial consequences to their family. We want people to know that hospice care helps relieves the stress of illness, it doesn’t add to it.”
Interested in learning more about Hosparus Health and what it can offer you or your family? Contact the Hosparus Health care line at (800) 264-0521, fill out their online form, or visit their website at HosparusHealth.org for further information.