Hijacking the Hospice Movement

Rodney Warner
Rodney Warner

Hospices perform a vital service.  They help care for dying patients.  They provide care that family members aren’t capable of performing, for people who don’t want to spend their last days in a hospital. But there are many hospices that are in it for the buck, according to a recent Washington Post article.

According to the article, there are a number of for profit hospices that are defrauding Medicare by providing hospice care (and being paid $150/day, whether care is actually provided to the patient or not) to people who are not terminally ill.  They estimate these operations are costing Medicare billions of dollars a year.

The Post looked at records of California hospices and found that from 2002 to 2012 there was a 50% increase in those who survived care that was supposed to help them die.  They found time spent in hospice care increased dramatically, while profits for caring for these people went from $353 per person in 2002 to $1,975 ten years later.

The Post states hospice care has become a $17 billion industry dominated by corporate ownership. These corporations are making billions of dollars giving hospice care to people who don’t need it.

At AseraCare, for example, one of the nation’s largest for-profit chains, hospice patients kept on living. About 78 percent of patients who enrolled at the Mobile, Ala., branch left the hospice’s care alive, according to company figures. As many as 59 percent of patients left the AseraCare branch in nearby Foley, Ala., alive. And at the one in Monroeville, 48 percent were discharged from the hospice alive.

In 2011, nearly 60 percent of Medicare’s hospice expenditure of $13.8 billion went toward patients who stay on hospice care longer than six months, MedPAC, the Medicare watchdog group created by Congress, has reported, according to the article.

One of the problems is that some of these hospices employ physicians who are filling out forms, and telling patients, they are terminally ill when in fact they are not, all to make more money. How are prospective patients found?  They’re recruited by hard sell sales tactics,

At AseraCare, officials gave advice to their recruiters on how to close a deal with families who are “not ready yet” for hospice, according to a company presentation for Alabama employees. It instructed recruiters to “focus families” by stressing the urgency of a decision, and saying things like, “We only have 10 minutes left.” “Effective communication is the transfer of emotion, not information,” the presentation said.

According to recorded conversations being used as part of a lawsuit against one hospice owner,

(A)t Angels of Hope hospice in LaGrange, Ga., audio recordings cited in the complaint described how some salespeople found patients: by cruising neighborhoods, looking for elderly people with disabilities. “How do you solicit patients?” a marketer is quoted as saying. “You see somebody sitting on the front porch in a wheelchair and you hit the brakes.”

This is another sad example of corporate America making billions of dollars off of vulnerable people and their families. Ten years ago I was told (incorrectly) I was terminally ill.  The experience has been burned into my brain.  The fact there are doctors lying to patients, telling them they will probably be dead within six months just to feed the corporate hospice machine more patients is despicable.

If you or a loved one are thinking about hospice care, I would suggest you do your homework.  Personally, I would steer clear of these business operations and focus on non-profit hospices (according to the Post, average stays in non-profit hospices are much shorter, indicating they are treating more people who are genuinely terminally ill). Don’t fall victim to the corporate hospice hard sell approach.

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