PLEDGE NOW
For-Profit Hospice Care: What Do We Make Of It?
In this 2009 file photo, Dr. Joel Policzer checks on Lillian Landry in the hospice wing of an Oakland Park, Fla. hospital. Unlike most of Policzer's patients she made end-of-life decisions. (AP File)

In this 2009 file photo, Dr. Joel Policzer checks on Lillian Landry in the hospice wing of an Oakland Park, Fla. hospital. Unlike most of Policzer’s patients she made end-of-life decisions. (AP File)

The for-profit hospice care is a growth industry in this country.  But taxpayer beware.  (And it is the taxpayer who is footing the bill, big-time.)

Investigations published in JAMA Internal Medicine (Journal of the American Medical Association), JMLE (Journal of Law, Medicine and Ethics), the Washington Post, Huffington Post, MEDPAC (which advices Congress on Medicare issues) and others do not paint a pretty picture.

Huffington Post investigative reporter Ben Hallman’s report is just out.  It had an especially eye-catching headline:  Hospice, Inc:  How Dying Became A Multibillion-Dollar Industry.  

On Point with Tom Ashbrook invited him on to talk about it this Wednesday, June 25.

Too many of these for-profit hospices are gaming US law and cherry-picking patients, finding ways to reap big profits from the Medicare system, taking people who will take longer to die –and sending them home if they take too long to die, so they can maximize profits.  And some of them –including big, national corporations — have been sued repeatedly by the federal government for their practices.  Patient for patient, the for-profits cost the US Treasury a lot more money.

Our guests today took pains to make clear that not all for-profits are bad and not all non-profits are good.  But the problem is real, as even as J. Donald Schumacher, head of a top industry trade group, the National Hospice and Palliative Care Organization (NHPCO), allowed: “…You can get a hospice license in this country and not be [inspected by regulators] for [up to] 20 years.”

Schumacher insists the problem is confined to a few outliers.   Maybe, maybe not.  I’d need somebody to explain to me whether ‘just a few outliers’ could, by themselves, cause the national bill for hospice care to increase well more than five times over since 2000.  (In 2000, Medicare-funded hospice care cost you and me and the rest of us a little under $3 billion.  In 2012, we paid out $15.1 billion.  Huff Po’s Ben Hallman puts our current annual tab at $17 billion.)  Talk about the little outlier that could.

Investigative reporting can be a blood sport sometimes.  At its worst, a reporter comes up with a handful of damning anecdotes and used them to tar a whole segment of society or the economy.  I thought our guests –including investigative reporter Ben Hallman—were very measured.  At their worst, in rebutting those investigations, industry officials spend our listeners’ time dodging questions and tossing out red herrings like confetti.

As great as it was to have Schumacher on, he represents both the for-profit and non-profit sectors.  You can’t pin the worst practices of a few national hospice corporations on him.  That’s why we invited on to the show top officials from Vitas, a big national hospice chain that has been investigated several times and is currently facing a federal lawsuit.  We felt they should be the ones to answer Hallman et al.

They declined through their publicist, who emailed to tell me the Huff Po story was “sensationalistic” and “misleading” They were glad, they wrote me, Schumacher was doing the interview instead [paraphrasing here].  We were disappointed.  I felt they had a duty, if not to worried listeners, if not to their client-patients, then at least to their shareholders, to address the charges that have been levelled against them on several fronts.

At the end of the hour, the conversation changed direction: The taxpayer and patient bottom lines aside, the personal bottom line remains.  Our guest, Dr. Diane Meier of Mt. Sinai and a real expert on this subject, was the main voice of authority at this point.  The takeaways from Dr. Meier and several other experts we spoke to are:  Choosing a hospice for your loved one is a tough decision too often left to the most trying of times.  Don’t leave it to the last second. Don’t let the hospices recruit you –they are coming to you (although a caller and hospice marketer said he resented being described as one of many “trolling hospital hallways for clients”), and you have to judge them worthy of your custom –and the public dollar.  Not all no-profits are good, not all for-profits are bad.  A little shopping around when you’ve got some spare time one day long before you have any cause to, will make your life and your loved one’s life a heck of a lot easier.

— Stefano Kotsonis, On Point producer 

Please follow our community rules when engaging in comment discussion on this site.
ONPOINT
TODAY
May 6, 2016
President Barack Obama drinks water as he finishes speaking at Flint Northwestern High School in Flint, Mich., Wednesday, May 4, 2016, about the ongoing water crisis.  (AP Photo/Carolyn Kaster)

It’s Trump for the GOP. Clinton leads. Sanders hangs in. A Navy Seal killed by ISIS. Our weekly news roundtable goes behind the headlines.

May 6, 2016
Close-up of a Grauer's gorilla. Kahuzi-Biega National Park, one of the last remaining strongholds of the 
Grauer
’
s gorilla, the 
world
’
s largest gorilla subspecies. 
CREDIT: A.J.Plumptre/WCS.

Great gorillas being wiped out by war and poaching. We’ll go to the mountains of Africa. Plus, after the Ivory burn in Kenya- we look at the state of the world’s elephants.

RECENT
SHOWS
May 5, 2016
Rob Reiner with his son, Nick. [Courtesy: Paladin]

Filmmaker, actor Rob Reiner and his son, Nick, get personal in their new film “Being Charlie,” which takes on drug addiction.

 
May 5, 2016
Detroit teachers march outside the district headquarters, Monday, May 2, 2016, in Detroit. Detroit Public Schools transition manager Steven Rhodes says 45,628 of approximately 46,000 students were forced to miss classes Monday as 1,562 teachers called in sick. The mass sick-out has forced the district to close 94 of its 97 schools. Detroit's schools are expected to be out of cash starting July 1. The state earlier gave the district $48.7 million in emergency funding to keep it open through June 30 as the Legislature considers a $720 million restructuring plan. (AP Photo/Carlos Osorio)

Fixing Michigan- from Flint’s water crisis to failing schools in Detroit. Are state takeovers the answers or the problem?

On Point Blog
On Point Blog
Devoured: We Are What (And How) We Eat
Tuesday, May 3, 2016

From chicken wings to kale smoothies, we look at what we eat, and how challenging it is to eat well in America.

More »
Comment
 
‘Embedded’: How Violent Gangs Are Terrorizing El Salvador
Thursday, Apr 14, 2016

NPR’s Kelly McEvers on her reporting in El Salvador for the podcast Embedded, and how gang killings brought San Salvador’s bus service to a halt.

More »
Comment
 
That Cheap Dress On Facebook? It Isn't Worth It
Monday, Apr 11, 2016

Know those shockingly cheap clothes you see advertised on Facebook? There’s a catch.

More »
Comment