Study finds that for-profit hospices may choose cheaper-to-treat patients

In a study published in JAMA, The Journal of American Medical Association, the study authors concluded that for-profit hospice agencies had a higher percentage of patients with diagnoses associated with lower-skilled needs and longer lengths of stay, when compared with nonprofit hospice agencies.  This has led other writers in publications such as the Los Angeles Times and Modern Healthcare to suggest that the for-profit hospices may be selecting patients who are less expensive to treat — leaving patients who are more costly to care for to nonprofit agencies.

The results of the study suggest that Medicare’s per diem payment structure may create financial incentives to select patients who require less resource-intensive care and have longer hospice stays.  We have been concerned for some time that Medicare’s policies have effects like this.  There can be a similar risk of “cherry picking” of patients by physicians and medical groups for the same reason.  Medicare’s “OASIS” rating system that publishes outcomes for healthcare providers may similarly encourage providers to shun patients who are so sick that they may produce bad OASIS scores for the providers.

The JAMA extract for the study can be found at this location:
Association of Hospice Agency Profit Status With Patient Diagnosis, Location of Care, and Length of Stay

Tim Colling
Tim Colling

Tim Colling is the founder and President of A Servant's Heart In-Home Care, which provided in-home caregiving services in San Diego County, and also of A Servant's Heart Geriatric Care Management, which provided
professional geriatric care management services and long term care placement services in San Diego County. Tim has more than 30 years of experience in management in a variety of industries. He held a Certified Care Manager credential from the National Academy of Certified Care Managers. Tim is also a Certified Public Accountant (retired), and received his Bachelor’s Degree in Accounting from California State University at San Diego. In addition to writing blog posts here for the Servant’s Heart blog, Tim also is a regular contributor to and to as well as blogs of other eldercare services provider companies. Finally, Tim is also the president of A Servant's Heart Web Design and Marketing, which provides home care marketing as well as website design and online marketing for those who serve the elderly and their families.

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