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For Profit Hospices Versus Non Profit Painting a Picture of Potential Cherry Picking-Could Happen With Data Created From Risk As

Posted Feb 01 2011 8:39pm

Yup, we can’t get away from it anywhere we go in healthcare, as insurers and everyone else lives and dies by the algorithms of cost.  When compared to non profits the number of cancer patients seen by for profits seemed dwarfed when compared.  As the article states, Medicare pays $143 a day regardless of how much care is needed and how often.  Ok so take the bean counters to get out their image numbers and do risk assessments against cancer patients and dementia patients and see who has the better profit numbers, no brainer here. 

Hospice care based on referrals by physicians and sometimes other individuals in healthcare.  There’s nothing today to stop a marketing campaign to go after patients in a nursing home with a lower percentage of cancer patients for an example, and that could be the case as nursing homes can and do specialize in what areas they can care for patients too. 

For profit hospice services do sell and solicit and I agree it’s not a wonderful job to have for sales, but it is done and even the MDs might have no idea what’s behind the over all scheme as they are just trying to make a good recommendation for their patient to get good care.  I think there could be something to this as the GAO is also looking into the quality of care that patients receive who are in “for profit’ centers owned by private equity firms to ensure they are getting the needed care.  BD

CHICAGO (AP) -- For-profit hospices may be cherry-picking the least costly, most lucrative patients, potentially putting the nonprofit industry at a financial disadvantage, a study suggests.

The researchers found hospice care provided by for-profit agencies averaged 20 days versus 16 days for nonprofit agencies. Care lasting more than one year was most common among for-profit hospice patients.

Also, compared with nonprofits, for-profits had about twice as many patients with dementia and fewer cancer patients. End-of-life cancer care is typically much more intensive and costly than dementia care.

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