Profiteering: Patient-Centered vs. Profit-Driven Hospice Care – Part 2

RESEARCH FINDINGS ON PATIENT CARE QUALITY

The Live-Discharge Rate

According to The Washington Post, which has published an extensive series of investigative reports under the title, “The Business of Dying,” more than one in three patients are being discharged from hospices before death. This live-discharge rate is a “sign of trouble,” according to The Washington Post.⁹ 

While it is normal for about 15 percent of hospice patients to be discharged before dying, often because their health improves, researchers with The Washington Post found that at some hospices, particularly those managed by newer, for-profit companies, the rate is double that or even higher. Mississippi and Alabama, for example, had rates of 41 and 35 percent respectively.¹⁰ 

Based on its analysis of more than 1 million U.S. hospice records from 2002 to 2012 and more recent supportive information from the federal government, The Washington Post attributes this discrepancy to two key factors: 

• For-profits seek to avoid paying for the more expensive care that patients often need as they approach death, and 
• For-profits actively recruit patients who aren’t actually terminally ill.¹¹ 

Avoiding costly care

As patients’ health deteriorates, their care needs can increase, both in quantity and cost. Researchers found that one in four patients discharged from hospice before death are subsequently admitted to a hospital within 30 days.¹² Through early discharge, the for-profit hospice avoids providing costly CT-scans, MRIs, and palliative radiation treatments. However, patients often then end up in emergency rooms and hospitals – the polar opposite of their originally expressed desire for comfort and familiarity at the end of life.¹³