Home Health & Hospice Week

New study keeps hot button issue of live discharges front and center.

Referral sources, potential patients and others may learn your live discharge rate, if regulators listen to the authors of a new study.

A survey of hospices conducted in 2008 and 2009 found that for-profit hospices had a higher disenrollment rate and cared for a larger proportion of patients with longer expected hospice stays, including those in nursing homes, than their non-profit counterparts, according to a study published in the Feb. 24 issue of JAMA Internal Medicine. For-profits also were more likely to exceed Medicare’s per beneficiary cap.

"Ownership-related differences are apparent among hospices in community benefits, population served, and community outreach," the study authors, including Melissa Aldridge, a health researcher at Mount Sinai School of Medicine in New York, say in the abstract. "Although Medic-are’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 urge.

If hospice patients and their families could determine which hospices were likeliest to bounce their patients, "we’d no longer see these substantial differences," Aldridge told the New York Times.

The study comes on the heels of scrutiny from The Washington Post, the Times, and other newspapers into the issue of hospice live discharges (see Eli’s HCW, Vol. XXIII, No. 1).

The study also points out some positives of for-profits, including their outreach to minority patient populations.

See the JAMA article’s abstract at http://archinte.jamanetwork.com/article.aspx?articleid=1832198#References.