Choosing a Home Health Agency, Mobile Doctor, or Hospice

When a hospital or rehab sends someone home with home health or hospice, the family gets to choose the company. Each service has its own first question. For home health and a doctor who comes to the house, start with insurance and service area. For hospice, start with the nurse.

Home health: insurance first, then the team

Find agencies that take your loved one's insurance and cover your area. With Original Medicare that is any Medicare-certified agency that serves you; a Medicare Advantage plan usually limits home health to agencies in its network.

After that, the most important factor is the nurse or physical therapist your loved one will work with most closely. Home health is usually short-term and rarely starts in an emergency, so there is often time to meet the team before you decide.

A recommendation from their primary care doctor carries real weight. Home health depends on close coordination with that doctor for updated orders, signatures, and instructions, and a doctor who prefers an agency usually does so because it communicates well, which leads to better care.

What should you look for in a doctor who comes to the house?

Start the same way: insurance and service area. Then meet the doctor, and pay attention to how easy they are to reach. Some give out a cell number for a quick text; others take days to call back. Personality and bedside manner matter too.

If your loved one lives in a community, how fast the doctor answers the staff matters a lot, because a slow doctor means delayed medication orders. Ask what their usual response time is, and hold them to it.

Hospice: the nurse matters most

For most families, insurance is not the deciding factor with hospice. Most people on hospice are over 65 with Medicare or a Medicare Advantage plan, and electing hospice moves its coverage to Original Medicare either way. Insurance only becomes a real factor with a commercial plan.

The biggest thing is the nurse: how comfortable your loved one and the family feel with them, how much they know, their bedside manner, and how well they communicate.

Where do the quality scores fit?

Medicare's Care Compare tool at medicare.gov lists home health and hospice agencies by area, with star ratings and patient and family survey results. Use them as a sanity check, never as the only reason to choose; they do not tell you who will walk in the door. Our directory lists every licensed home health and hospice agency in each state we cover.

This article is general information for family caregivers, not medical advice.