Are Hospice Providers Using Live Discharge To Cut Costs?

August 26, 2014
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A study published in the Journal of Palliative Medicine entitled “A National Study of Live Discharges from Hospice” was conducted due to the concern that discharging patients from the hospice program may be a way for providers to cut costs. The writers state, “A concern with hospice live discharge is that they may reflect improper behavior on behalf of the provider. For example, the pattern of hospice discharge followed by a hospital admission and hospice readmission may represent a family who panicked, but it may also represent a hospice effort to avoid the costs of a hospitalization related to the terminal illness.” It is suggested that this may be a reflection on the current Medicare hospice benefit, as hospice providers may be discharging to avoid costly care. The study determined that not-for-profit and government run hospice programs were the least likely to have live discharge. There are many reasons why a live discharge may occur, but this topic is currently being researched to determine whether the current pattern of live discharge (18.1%) is in the best interest of the care recipient or an unethical tactic used by providers. Researchers advise, “Hospices with high rate of these patterns of live discharges should trigger further regulatory review that examine whether their hospice enrollees were eligible, adequately informed about the Medicare hospice benefit before electing hospice, and whether the hospice program did a good enough job of advanced care planning to avoid hospitalizations.”

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