Hospices have become big business for private equity firms, raising concerns about end-of-life care

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The ability to turn a quick profit in caring for people in their last days of life is attracting a new breed of hospice owners: private equity firms.

in an analysis of federal data from 2014 to 2017 that patients in for-profit hospices were less likely than patients in nonprofit hospices to have received any hospice visits in the last three days of life.According to the, for-profit hospices had Medicare profit margins of 19% in 2019, compared with 6% for nonprofit hospices.

“It is a very simple business model,” Teno said. “Go to assisted living facilities and nursing homes, and it’s one-stop shopping.”The Rev. Ken Dugger has worked as a chaplain in Denver for 13 years at both for-profit and nonprofit hospices. “Some people see dollars and they go, ‘Wow! It’s a great chance to make some money here,’ and they don’t understand that hospice isn’t easy,” Dugger said.

by the Milliman consulting firm found that 31% of patients in nonprofits had cancer, while 15% had dementia. At for-profit hospices, 22% of patients had cancer, and 22% had dementia, said the report, funded by the National Partnership of Hospice Innovation, a trade group of nonprofit hospices. Because hospices are inspected every three years, some are bought and sold without a state or federal inspection — and sometimes without regulators even knowing about the sale.

Many nonprofits believe private equity-backed and other for-profit hospices are giving the industry a bad name.

 

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