Booming for-profit hospice care leads to 'cherry-picking' concerns

For-profit hospice care has grown at a stupendous rate, possibly complicating the financial aspects of transferring a patient out of hospital care, concludes a study recently published in the Journal of Law, Medicine and Ethics.

For-profit hospices grew 128 percent between 2001 and 2008, according to "In the Business of Dying: Questioning the Commercialization of Hospice." By contrast, government-run hospices grew by just 25 percent, while non-profit hospices grew by just one percent.

The study's authors suggest that for-profit hospices have focused on both aggressive marketing efforts and "cherry-picking" of particular patients to boost profits.

"It turns out that in part they're doing it because they are very selective about the types of patients that they treat. So there's clearly a strategy whereby they're going to target the patients that are least costly to care for," Joshua Perry, one of the study's authors, told Healthcare Finance News.

Medicare pays the same per diem rate for hospice care no matter their illness, creating a perverse incentive to select patients who would remain in hospice care longer. That means patients with dementia would likely be preferable over those with cancer, notes Perry. Conversely, hospitals may find it more difficult to move cancer patients--who are very expensive to treat--into hospice care.

However, a spokesman for the National Hospice and Palliative Care Organization said such practices would be illegal.

For more:
- here's the study (.pdf)
- read the Healthcare Finance News article