Operational and Financial Performance of Publicly Traded Hospice Companies

McCue, Michael; Thompson, Jon M.

doi:10.1089/jpm.2005.8.1196

Cited by 22 publications

(16 citation statements)

References 12 publications

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“…Although it is not known if patient and family choice between hospices is associated with higher quality care for patients and families, there is mounting evidence that hospices vary nationally in program structure [19][20][21][22][23] and patient care. [24][25][26][27][28][29][30] Future studies regarding the extent to which having greater choice between hospices improves a family's ability to find a hospice that meets their needs and the potential linkage between hospice choice and hospice quality of care are needed.…”

Section: Discussionmentioning

confidence: 99%

Geographic Access to Hospice in the United States

Carlson

Bradley

et al. 2010

Journal of Palliative Medicine

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Section: Discussionmentioning

confidence: 99%

Geographic Access to Hospice in the United States

Carlson

Bradley

et al. 2010

Journal of Palliative Medicine

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“…To investigate factors that could drive differences beyond profit status alone, prior studies have analyzed the impact of agency size and tenure in the marketplace, for instance finding that smaller and newer for-profit agencies have higher rates of live discharge and longer lengths of stay than other agencies. (11, 13, 14) Few analyses of hospice care have explored the role of the agencies’ parent companies. Analyses based on a national survey of hospice agencies included chain status as a control variable in examining for-profit vs. not-for-profit differences in enrollment practices and the provision of community benefits; (4, 15) another article using the same dataset examined the influence of chain status on self-reported care practices, finding that chain agencies (the article did not distinguish between for-profit and not-for-profit chains) generally offered higher quality of care relative to non-chains.…”

Section: Introductionmentioning

confidence: 99%

Effect of Ownership on Hospice Service Use: 2005–2011

Stevenson

Grabowski

Keating

et al. 2016

J American Geriatrics Society

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Background/Objectives For-profit agencies comprise the majority of all United States hospice agencies, prompting concerns about aggressive enrollment practices and deficient care. Using detailed administrative data from 2005–2011, we sought to assess differences in patient populations and service use by hospice ownership, chain status, and agency size. Design/Participants Retrospective cohort study of 5,405,526 Medicare beneficiaries age 65+ enrolled in hospice during 2005–2011. Hospice use by ownership category (for-profit non-chain and chain, not-for-profit non-chain and chain, government) and agency size (0–50 patients, 51–200, 201–400, 401+). Mean length-of-use, stays ≤3 days, stays ending with live discharge, and decedents receiving no general inpatient care (GIP) or continuous home care (CHC) level hospice in the last 7 days of life. Results After adjusting for patient and geographic differences, for-profit non-chain and chain agencies had longer mean lengths-of-use (84.5 and 91.2 days, respectively) than other agency types (66.3–72.5 days); higher rates of live discharge (21.0% and 20.2% versus 14.6%–15.9%); and lower proportions of stays of ≤3 days (13.9% and 14.7% versus 16.6%–17.5%) (all p-values<0.001). The proportion of decedents not receiving GIP/CHC level care before death was highest among for-profit chains (75.9%) and lowest among not-for-profit non-chains (63.2%). Across ownership categories, smaller agencies had longer mean lengths-of-use, higher live discharge rates, lower rates of stays ≤3 days, and higher rates of patients receiving no GIP/CHC level care. Considerable variation in patient traits and unadjusted service use existed among the nation’s largest chains. Conclusion Although for-profit and not-for-profit hospice agencies differ along key dimensions, our results convey substantial heterogeneity within these categories, highlighting the need to consider factors such as agency size and chain affiliation in understanding variations in Medicare beneficiaries’ hospice care.

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“…6 A recent study found that higher revenues have contributed to higher profitability for publicly traded hospices. 7 The median profit margin in 2003 for large hospices owned by publicly traded companies was 18.2% compared to a median value of only 2.2% for nonprofit hospices. 7 As a result of this growth in earnings, these companies have been able to access the capital markets to fund their acquisition of existing not-for-profit community hospices and/or the development of new hospices.…”

mentioning

confidence: 97%

“…7 The median profit margin in 2003 for large hospices owned by publicly traded companies was 18.2% compared to a median value of only 2.2% for nonprofit hospices. 7 As a result of this growth in earnings, these companies have been able to access the capital markets to fund their acquisition of existing not-for-profit community hospices and/or the development of new hospices. 8 The operational performance of hospices has become a topic of interest recently in the health care and management literature due to the widespread growth of hospices and the growing acceptance of hospices by providers and the public.…”

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confidence: 97%

Operational and Financial Performance of Newly Established Hospices

McCue

Thompson

2006

Am J Hosp Palliat Care

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The objective of the study was to examine the financial and operating performance of newly established, free- standing hospices relative to existing, freestanding hospices. A nonparametric median test was used to compare the median values of operating and financial performance measures between newly established hospices and existing hospices. Operating and financial data were measured for the 2 groups using cost report data from the Centers for Medicare and Medicaid Services. The authors sampled 44 new, freestanding hospices and selected 312 freestanding existing hospices and analyzed their data over 2 years from 2002 to 2003. The study found that 91% of these new hospices were owned by for-profit organizations and were located in the southern region of the United States. New hospices served fewer patients; however, they had a longer length of stay compared to existing hospices. They offered fewer imaging services and radiation therapy services. New hospices generated significantly higher revenue but incurred significantly higher expenses. The results suggest that longer lengths of stay allow these newer hospices to increase revenue and improve overall profitability.

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Operational and Financial Performance of Publicly Traded Hospice Companies

Abstract: Results suggest publicly traded for-profit hospices, in comparison to for-profit and nonprofit hospices, are able to earn substantially higher profits.

Cited by 22 publications

References 12 publications

Geographic Access to Hospice in the United States

Geographic Access to Hospice in the United States

Effect of Ownership on Hospice Service Use: 2005–2011

Operational and Financial Performance of Newly Established Hospices

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