Donald Schumacher: Hi! I am Donald Schumacher, President and CEO of the National Hospice and Palliative Care organization and we are talking about hospice Care. Now I am going to talk with you a little bit about how hospice care is actually paid for. Americans have a wonderful opportunity when they face their terminal illness to have Hospice Care paid for by most health insurances in this country, we are very unique in that in this country and in another parts of the world, Hospice services or end of life care services in general are not paid for by any form insurance. That of course leads to all sorts of financial issues as well as quality issues. Here in the United States, Medicare pays for just about all of the hospice care in the country because about 90% of out patients are Medicare beneficiaries. In addition to that Medicaid those individual who are on Medicaid can also receive hospice services which largely parallel the Medicare system. In addition to that individuals who are younger or have insurance of a commercial nature can have hospice paid for by their insurances as well. Medicare Hospice Benefit access essentially the gold standard of hospice care and that it covers the all of the services that the patient would need. The doctor, the nurse, the social worker, pastoral care person the drugs the biological, the volunteers, the bereavement support everything that you might need in order to have a hospice experience that awards you the individualized care plan opportunity that people really do benefit from as they move towards the end of their lives. So payment is not an issue, the issue always remains when to make the referral, now once the referral is made and the patient has been admitted and the care has been commenced then your insurance company will pickup the care for you and will provide the reimbursement to the hospice provider. It's a unique benefit here in this country it's been enacted here in the United States under Medicare since 1982 and it is something that many other countries in the world envy as there is a reimbursement stream that will cover this very important service. Regardless of you insurance all hospices are committed to providing good comprehensive care to every patient who needs regardless of their ability to pay. So hospice care also excels at providing supportive services to people who don't have insurance or who don't have any kind of other coverage or can't pay for it. Next we are going to talk with you about how you go about choosing a hospice program.