Over four in 10 Americans die in hospice care, or end-of-life care that focuses on palliation, or pain alleviation. Unfortunately, the growth of for-profit hospice care has augured corruption in the form of more patients, longer stays, and higher costs.
Although a prognosis of six months or less to live guarantees Medicare eligibility for hospice care, 20% manage to survive longer than 6 months. Meanwhile, caretakers are paid and patients are recertified.
A surplus of eligible patients has made for good business. In 2009, the amount of Medicare hospice patients in 2000 had doubled to 1.1 million. The Medicare bill quadrupled to $12 billion. However, the quality of services has decreased, as almost a third of patients do not get contractually-obliged care services and visits.
It is primarily for-profit centers that fill their patient rosters with the non-terminally-ill. They often diagnose patients with ambiguous ailments, like "failure to thrive," or "debility." Non-profits, on the other hand, tend towards "faster-killing conditions like cancer," according to a Harvard study. Thus, for-profit patients spend an average of 98 days in hospices, while their counterparts in non-profits spend 68 days. For-profit patients reap 29% higher costs ($12,609) than do non-profit patients, and Medicare has been happy to foot the bill. The profit margin for for-proftis is 10%, whereas non-profits are at 0.2% -- a factor difference of 50.
Keep an eye out for Part 2 of this series addressing end-of-life care and the people who provide it.
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