Home Health	Hospice
Criteria	Patient has a medially skilled need, usually following an acute hospitalization.	Patient has a life-threatening illness and is seeking a palliative approach to care. No skilled need required. Care may begin at anytime from any setting.
Goal	Discharge after medical improvement.	Comfortable living and peaceful death.
Course	Patient is very ill at onset of care and condition gradually improves.	Patient may be quite stable at onset of care with few, if any, skilled needs and condition gradually declines.
Unit of Care	The patient.	The patient and their family - "family" is defined by the patient.
Providers of Care	Individual professionals as indicated by the patient's specific skilled needs.	An interdisciplinary team comprised of a variety of healthcare professionals and volunteers. The team provides total case management across the patient's full range of care needs.
Emergency Care (off hours)	A phone message instructs the patient to call 911 if there is a medical emergency.	A comprehensive on-call system available 24 hours a day, 7 days a week that acts as an alternative to calling 911.
Focus of Care	Usually medically directed towards improving physical health and ultimately achieving self-care.	Palliative care (comfort) when cure is no longer possible. Care plans address the physical, psycho-social, and spiritual needs of the patient and family.
Continuity of Care	Does not continue in other settings such as acute care.	The interdisciplinary care planning continues in any care setting, including an acute level of care.
Scope of Services	Limited to skilled needs.	Offers many extra services such as bereavement care, support groups and volunteer help.
Staff Training	Traditional - broad scope.	Specialized training in palliative care for the terminally ill.
Reimbursement	Typically, fee per visit or episodically (PPS).	Typically per diem by level of care. The Medicare levels of care are: routine home care, inpatient respite care, continuous care, and acute inpatient care. The per diem covers cost not typically paid for on a per visit basis: Chaplain services Counseling /social work for the family unit Interdisciplinary team Volunteers (and the administrative costs associated with this service) Comprehensive on-call system during "off" hours Interdisciplinary team meetings Specialty consultation and care planning by the hospice medical director Bereavement care for the patient's family up to 13 months after the patient's death