Report on Hospice Care Shows Cost and Quality Differences Between Nonprofit and For-profit Hospices.

Courtesy Home Hospice of Grayson

A report released by the National Partnership for Hospice Innovation (NPHI) highlights several cost and quality differences between for-profit and nonprofit hospices serving Medicare beneficiaries. The report, prepared by the global actuarial and consulting firm Milliman, confirms three differences between the hospice types.

Compared to for-profit hospices, nonprofits:

1. Report higher costs per day for direct patient care

2. Have fewer patients who discontinue hospice care

3. Generate lower Part A costs for Medicare in the subsequent 90 days among those patients who do decide to discontinue hospice care.

The report also found that nonprofit hospices enroll a higher percentage of patients who had an inpatient stay immediately prior to their hospice admission. This finding suggests they may be high-acuity patients with greater care needs on hospice enrollment. Meanwhile, for-profit hospices report lower spending and fewer visits per patient day for nursing care, therapy, and social worker services than nonprofit hospices.

As for advertising, for-profit hospices report spending over 300% more on advertising costs than nonprofit hospices. And, for-profit hospices report spending less than half what nonprofit hospices report on bereavement services.

Compared to nonprofit hospices, for-profits have nearly twice the rate of live discharges. Patients discharged alive from for-profit hospices went on to incur higher Medicare Part A costs in the weeks and months post-discharge.

In 2017, nonprofit hospice programs operated at a net aggregate Medicare margin of 3.0 percent, while for-profit programs operated with a margin of 19.9 percent. This finding of a significant differential in the Medicare margin is consistent with the last several annual reports by the Medicare Payment Advisory Commission (MedPAC), a nonpartisan Congressional advisory panel.

John Richardson, NPHI Chief Strategy Officer, says, “We believe the findings of this deeply- researched expert report are consistent with and reinforce the findings of the most recent reports on the Medicare hospice benefit from the HHS Office of Inspector General, Government Accountability Office, and the Medicare Payment Advisory Commission. All have found significant differences between nonprofit and for-profit hospices in the stewardship of Medicare dollars and the quality of care for Medicare beneficiaries.”

Have questions about the best quality of care and support? Give us a call at 903-868-9315 or visit us online at for more information from the area’s only non-profit hospice––Home Hospice of Grayson, County and Fannin Counties.