For-profit hospices serve more extended-stay patients, are more likely to exceed Medicare cap than nonprofits, study finds

Share this article:

For-profit hospices serve more extended-stay hospice patients than nonprofits, and are much more likely to file claims that exceed Medicare's aggregate annual cap for the hospice benefit, according to newly published findings.

Investigators at the Mount Sinai School of Medicine in New York City analyzed data from nearly 600 Medicare-certified hospices nationwide.

About 30% of patients at for-profit hospices have a “longer expected stay,” compared with 25% in nonprofit hospices, the researchers found. For-profit providers also were more likely than nonprofits to exceed Medicare's annual cap on hospice reimbursements, at a rate of 22% vs. 4%.

In addition, 10% of patients in for-profit hospices disenroll prior to death, compared with 6% in nonprofits.

“Although Medicare's aggregate annual cap may curb the incentive to focus on long-stay hospice patients, additional regulatory measures such as public reporting of hospice disenrollment rates should be considered as the share of for-profit hospices in the United States continues to increase," wrote the study authors.

The findings appear in JAMA: Internal Medicine.

Share this article:

More in News

Long-term care continues to lead in deal volume and value: PwC report

Long-term care continues to lead in deal volume ...

Long-term care bucked healthcare industry trends with strong merger and acquisition activity in the second quarter of 2014, according to newly released data from professional services firm PricewaterhouseCoopers.

Empowering nurse practitioners could reduce hospitalizations from SNFs, study finds

Granting more authority to nurse practitioners is associated with reduced hospitalization of skilled nursing facility residents, according to recently published findings.

Pioneer ACO drops out of program, despite reductions in skilled nursing utilization

A California healthcare system has become the latest dropout from the Pioneer Accountable Care Organization program, despite reducing skilled nursing facility utilization and improving its readmission rates. Sharp HealthCare announced its decision in a quarterly financial statement released Tuesday.