As hospice care has evolved from its charitable roots into a $14 billion business run mostly for profit, patients like Covington and their families have paid a steep price, according to lawsuits and federal investigations. Providers have been accused of boosting their revenues with patients who aren’t near death and not eligible for hospice — people healthy enough to live a long time with traditional medical care. In hospices, patients give up their rights to “curative” measures because they are presumed to be futile.
In 2009, a Medicare oversight report found nearly a third of hospice patients were not getting services in care plans that describe the treatment and visits providers promise to give them.
Medicynical Note: Left to themselves without standards or oversight, businesses work to maximize profit. In other areas, competition may work to assure quality. In hospice care such competition may work as well but that remains to be seen. What is certain, however, is that in the rush for immediate profit patients suffer needlessly.
In our local area, our “non-profit” hospice recently opened an inpatient facility. It was a financial stretch. To pay for it the hospice, it appears, is emphasizing the need for patients to reside in their facilty rather than remain in their home. This increases their payments from medicare and supports the inpatient facility but undermines the desire of many patients to be in their familiar home setting during the last stage of their illnesses.
And, the remarkably dysfunctional House of Representatives voted thursday to decrease the reach and function of the new consumer protection agency. They find it unimaginable that consumers should be protected.