Anyone who has had to deal with Hospice for a loved one has to been impressed with the level of compassion and concern and caring they bring.
But they are not all the same, and a paper in JAMA Internal Medicine finds a way to create a little bit of class warfare about that.
In 2011, 51 percent of hospices were for-profit. That's much different that the 5 percent that were for-profit in 1990. What does that really mean? The biggest misconception among the public is that for-profit is bad and not-for-profit must be good. They both have to make a profit. United Way does not pay its CEO $700,000 a year because it loses money. A non-profit simply does not pay a dividend to shareholders the way a public corporation does. More Baby Boomers have started to die and that means more hospice.
A non-profit also has access to funding that a for-profit won't have, primarily government. As a result, the new paper found that the tax status of a hospice (for-profit vs. nonprofit) affected community benefits, the population served and community outreach. All areas that are outside service delivery, but worth writing about.
The authors examined the association between hospice profit status and the provision of community benefits (charity care, research and serving as training sites), populations served and community outreach in 591 Medicare-certified hospices around the country. They found that compared to nonprofit hospices, for-profit hospices:
- Were less likely to provide community benefits, including serving as training sites (55 percent vs. 82 percent), conducting research (18 percent vs. 23 percent) and providing charity care (80 percent vs. 82 percent)
- Cared for a larger proportion of patients with longer expected hospice stays, including those in nursing homes (30 percent vs. 25 percent)
- Had higher patient disenrollment rates (10 percent vs. 6 percent, patients who don’t remain in hospice until their death)
- Were more likely to exceed Medicare’s aggregate annual cap, which is a regulatory measure to control hospice length of stay and constrain Medicare hospice expenditures, (22 percent vs. 4 percent)
- Were more likely to do outreach to low-income communities (61 percent vs. 46 percent) and minority communities (59 percent to 48 percent), suggesting that the growth of the for-profit sector may increase the use of hospice by these groups and address disparities in hospice use.
- Were less likely to partner with oncology centers (25 percent vs. 33 percent)
“Ownership-related differences are apparent among hospices in community benefits, population served and community outreach. 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,” they conclude.
JAMA Intern Med. February 24, 2014. doi:10.1001/jamainternmed.2014.3.
- PHYSICAL SCIENCES
- EARTH SCIENCES
- LIFE SCIENCES
- SOCIAL SCIENCES
Subscribe to the newsletter
Stay in touch with the scientific world!
Know Science And Want To Write?
- Why I’ll Talk Policy With Climate Change Deniers But Not Science
- Today's Global Warming Is Nothing Special
- HIP 116454b Shows That Despite Malfunction, Kepler Can Still Find Planets
- Worldwide, Life Expectancy Has Gone Up Over 6 Years Since 1990
- There Was No 'Paleo Diet' - Ancient People Ate What They Had
- Curiosity Detects Spike In Methane, And Other Organic Molecules, On Mars
- You Can Self-identify With Any Ancestry You Want, But Genetically...
- "You spend a great deal of time on the ideological motivations of climate change deniers, but mistakenly..."
- "Or we can blame my mother. It was to be their senior trip in 1959 but Castro and Che Guevara got..."
- "Solution aversion is very real. Talking about solutions which the climate skeptics could live with..."
- "For the avoidance of doubt, as judges are wont to say, it was Buckminster Fuller himself who first..."
- "Thank you for including the Four Myths of Nature. It is very helpful to keep these in mind when..."
- Tooth loss linked to slowing mind and body
- Latest evidence on using hormone replacement therapy for treating menopausal symptoms
- Less than half of UK prescriptions for antipsychotics issued for main licensed conditions
- Don't be tempted to buy your teen a cheap (old) car, parents warned
- The Lancet: Doctor who survived Ebola received experimental drug treatment