Miracle Cures

How often do the terminally ill avoid death? More often than you think. This is from our Daily Policy Digest:

Hospice patients are expected to die. Indeed, to enroll a patient, two doctors certify a life expectancy of six months or less. But over the past decade, the number of “hospice survivors” in the United States has risen dramatically, in part because hospice companies earn more by recruiting patients who aren’t actually dying. Healthier patients are more profitable because they require fewer visits and stay enrolled longer, says the Washington Post.

  • The proportion of patients who were discharged alive from hospice care rose about 50 percent between 2002 and 2012, according to a Post analysis of more than 1 million hospice patients’ records over 11 years in California, a state that makes public detailed descriptions and that, by virtue of its size, offers a portrait of the industry.
  • The average length of a stay in hospice care also jumped substantially over that time, in California and nationally, according to the analysis.
  • Profit per patient quintupled, to $1,975, California records show.

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.

The trend toward longer stays on hospice care may be costing Medicare billions of dollars a year. 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. (Washington Post)

Comments (16)

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  1. Chris says:

    Leaving hospice alive != living or surviving. You’re jumping to a conclusion. The patient may have been transferred to a different facility, or went home to die (using a separate home hospice service). Your data doesn’t show how long the person lived once they left hospice, which is a rather important bit of data if you want to be able to draw any sort of conclusion. One week? One Month? One Year? Still Alive Today? It’d obviously make a difference.

  2. Ted says:

    If the entire purpose of hospice is to care for those that are going to die, how is it ok for hospice providers to recruit patients who will clearly survive?

  3. Studebaker says:

    Hospice patients are expected to die. Indeed, to enroll a patient, two doctors certify a life expectancy of six months or less. But over the past decade, the number of “hospice survivors” in the United States

    We’re all dying — the difference is some are going to die sooner than others. Maybe I can move into a hospice in anticipation of my impending death — 50 years from now.

  4. Buster says:

    Surely there must be something that could be done to alleviate the perverse incentives. If life expectancy is six months, then why not cap benefits at six months? If people are leaving the hospice alive, then require the hospice to give back a month’s worth of care for every month a patient lives beyond discharge, up to 75% of all billed hospice charges.

  5. Lacey says:

    Could the fact that people are living longer simply be a product of advances in medical technology?

    • Mary says:

      If it is, then the industry needs to reevaluate its screening processes. Unless they’re switching to another hospice agency, the whole point of hospice is that you’re not planning on leaving alive.

  6. Lucas says:

    We should only live so long.

    • Trent says:

      Yes, we are slowly extending our lives past optimum efficiency. We’re becoming drains on the economy

  7. Trent says:

    “Hospice patients are expected to die: The treatment focuses on providing comfort to the terminally ill, not finding a cure. To enroll a patient, two doctors certify a life expectancy of six months or less.”

    Billions could have been spent elsewhere.

  8. Jimbino says:

    Wow. If I get ill, I’ll try to check into a hospice, since they seem to have a better record in keeping folks alive than docs and hospitals do. Probably less risk of nosocomial and iatrogenic illness, too.