November 29, 2022 An article published yesterday by ProPublica and digitally released in The New Yorker, How Hospice Became a For-Profit Hustle, outlines multiple instances of fraud targeting the Medicare hospice benefit. It illustrates how patient care suffers when bad actors are able to manipulate its original intent and purpose. We at the National Partnership for Healthcare and Hospice Innovation (NPHI) welcome this much-needed conversation and believe this is an opportunity to jumpstart the dialogue on reimagining the future of the benefit in a manner that removes incentives driving bad behavior while encouraging the delivery of holistic, person-centered care at the end-of-life.
NPHI, as the member organization representing the original mission-driven, community-based, non-profit, safety-net end-of-life providers, has been well-aware of the growing problem of fraudulent and harmful practices by some for-profit and private equity-backed providers. Ms. Kofman’s article brings some of these to light and cries out for more targeted and effective enforcement by federal and state authorities of existing hospice requirements.
The corrosive and harmful effects of profiteering are being felt throughout healthcare. As a recent study commissioned by NPHI and conducted by SIR and Emergence Creative, Views and Experiences of Aging & End-of-Life Care in the US, shows – only 31% of people trust the healthcare system and only 18% trust that system to put people’s well-being ahead of profits. We found, however, that hospice stands out as care people still trust and value. Medicare beneficiaries, their families, well-meaning providers, and the Medicare program itself cannot afford to allow further erosion of trust and confidence by patients and their families in the organizations providing high-quality care at the most vulnerable periods of life.
Trust and confidence are built over time through strong community ties and decades of experience providing the full hospice care model through the end of life. NPHI members provide the full hospice experience, including services above and beyond those required by the benefit. In 2021, they cared for over 450,000 beneficiaries and their families, provided $61M in charitable care, and tapped into 1.3M volunteer hours – all to ensure dignified and respectful end-of-life care is available to people in their respective communities.
The abuses detailed in the article call for a reform of the Medicare hospice benefit that can reduce the opportunities for fraud and abuse but also build a stronger pathway for advanced illness and end-of-life care providers to offer a better care experience for patients and their families. We look forward to working with our partners in government and our hospice colleagues to better target and strengthen program integrity efforts and enact a more robust Medicare benefit.
Tom Koutsoumpas CEO, National Partnership for Healthcare and Hospice Innovation
Carole Fisher President, National Partnership for Healthcare and Hospice Innovation