Posted on 12/27/2013 3:01:19 AM PST by afraidfortherepublic
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.
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 arent actually dying, a Washington Post investigation has found. Healthier patients are more profitable because they require fewer visits and stay enrolled longer.
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.
This vast growth took place as the hospice movement, once led by religious and community organizations, was evolving into a $17 billion industry dominated by for-profit companies. Much of that is paid for by the U.S. government roughly $15 billion of industry revenue came from Medicare last year.
(Excerpt) Read more at washingtonpost.com ...
In my mother's case the referral was made June 17 and she refused. Made several times afterwards with the same results. She finally relented on September 2 when she asked ME to sign for hospice for her. She died on September 5.
It seems to me that the scam of hospices is this:
At the end of a person’s life his health care costs become very expensive. The cheaper, more common, medicines and devices fail and the choice is either to use more expensive and sometimes questionable or even experimental treatments, or else to give up.
If a nurse or social worker talks a patient or his family into hospice care the following happen:
The patient’s healthcare provider does not have to pay for drugs and devices. That saves them apt of money.
The hospice owner has to treat pain and new acute conditions. These are not expensive to treat in general so it is relatively inexpensive for the hospice.
My understanding is that the hospice gets paid on a per-patient basis. The less medical care that is provided, the greater the profit for the hospice.
The only way this system can exist is if patients and their families give up hope of surviving the diagnosed illness that is thought to be killing the patient. The hospice system reaches the patients and their families with furrowed brows, phone calls, notes, cookies and other indicators of “compassion”. Some of the people who work there may be compassionate in real life, but the business model works if lots of people come in, they don’t get potentially life-saving treatments and they die quickly.
Hospice is a program where people with less than 6 months to live stay at a family member's home for the duration. Not sure what you were referring to with your comment "put somebody in hospice".
For medicare patients, I can see them limiting doctor visits, medicines and hospital admissions. Not sure how that is going to work out (not well, of that I am positive). Will they allow hospitals to refuse admission? Doctors to refuse to treat?
I don’t know if it’s cheaper or more expensive but my sister is in “hospice care in Mo. She is not in an institution but has around the clock care in her home.
It started 3 weeks ago and she is not expected to recover, she has liver cancer and all chemo and radiation therapy stopped about a month ago.
When hospice care first started, the doc told her that she had “days” left, not “weeks”.
Another stupid thing is Medicaid/Medicare pay for equipment rental when it would be cheaper to just buy the equipment. My husband was severely injured in a wreck seven years ago. Medicaid paid for months a toilet and walker. The monthly payments would have been able to buy the equipment in two or three months.
I also work in a nursing home and we have about ten residents on hospice. One lady in particular has been on hospice since I started working there almost two years ago. As far as I can tell, her condition is still the same. She doesn’t talk or walk and she can’t feed herself but she has been in that condition for a long time. I really don’t see how hospice helps her at all. Just one example of many, I’m sure.
Sad so many millions are wasted by idiots in charge.
I believe I was mistaken. I think hospice reimbursement ends when the patient dies, and therefore hospices seem out residents who can live under hospice authority for some time but are not receiving expensive treatments. Since hospices are not reimbursed for curative treatments that are intended to make the resident better but are reimbursed only for palliative treatments that reduce pain, the cost of medication is not much.
Instead of providing medical care to help the resident recover a hospice will slather on the “compassion” and work to keep the resident and his family from demanding curative medical care.
You get more of what you pay more for.
Agreed Gaffer. Also, there’s a lot of fraud in Medicare...especially in the black community. Sorry, facts are facts. Like getting a ride with the ambulance to the city hospital only to say, oh wow... I feel so much better...and going to visit a friend. This cost the tax payers $400,000 over a period of one year. (some people have big balls and a lot of gall) Or getting a ride from NY City to Albany on the Medicare teat.
There are “hospice houses” and some patients in nursing homes are “on hospice”. It isn’t just at home.
I am pretty familiar with Hospice locally and I only know of one patient who was released, and he died a month later.
I do know of a couple who asked to go home to die and the family took them, but hospice visited.
Coming from the Washington Post gives me the idea this story is BS.
When you distribute resources according to need, people get clever in demonstrating need, and hiding ability.
I was wondering about the use of the term draining in regard to money being spent on dying people who were promised that money
Sorry, my grandmother was “put” into a hospice. Only reason I used the reference.
I share your concern.
One of my pet peeves are the fat slobs, I mean really obese, that get’s on one of those things at a Walmart. All the scooters are being used by worthless trash that are too lazy to walk so the elderly and genuinely handicapped can’t use them.
Catheters delivered to your door? Uh all that means is USPS or UPS etc delivers them from a supplier. Wally World and even most drug stores do not carry them. Documentation of need should be required and in my caregiver experiences with Ostomy supplies is required for Medicare coverage and supplies are limited per month. IOW for Medicare to cover it takes a prescription, It also takes one for a Hover Round to bill Medicare. Blood Tester delivered to your door? I think Medicare does allow for a blood sugare level tester for Diabetics. Makes logical sense as an ER visit is a fraction of cost. The testers would be under $75. Do the Math.
Medical Transport Vans? Yea those are needed as well for many. We don't use one we have our own van with a hydraulic wheelchair lift. Now go out to a car lot and find a High Top Conversion Van. You can't find them. Our is a 1998. That was as new as we could find after a month lomg search. We bought then van and the lift was a hand me down from a cousin we've used for a decade.
In many places buses do not have wheelchair lifts. Also the transport {actual ambulance} service even with paramedics may be needed to transport the person from home where family does care to the doctor for such things as pressure sore treatment, doctors appointments, etc. Pressure sores happen for many reasons.
The ironic thing is you complain about the cheapest cost. Want to know what cost as in tens of thousands of dollars a year {in the neighborhood of about $50K-$75K just for a room and food? Try nursing homes. That doesn't include medications or any other supplies. They are the ones getting the biggest chunk of the medicare dollars. Persons on Home Health get the least. Home Health Services are very limited usually they are there to teach.
Go look at the link I posted earlier. These are not people that I’d consider abusive of the system. Likewise, all the items I posted as examples are abused. I did not intend to imply that everyone who uses them are undeserving.
Ok then are you as angry about persons who walk to the store then? The use should obey all traffic laws that apply to pedestrians.
The user should also have the cognitive ability to use them. I'm not sure a cab driver would be take the liability of breaking one down for a customer. They don't just fit in any car either. Ever seen a city bus driver do that? No? They are built to go on floors, parking lots, and sidewalks. Oh and just because a person is handicapped doesn't mean they are mentally incapacitated. But they do have to eat just like you now don't they? How are they going to get their groceries then?
Maybe they were the ones jogging down the road a year or two before and wore out their joints from the abuse pavement or concrete causes. There is also non visible things like MS. Look it's just common sense that when injuries or disabilities occur the ability to exercise is often deminished.
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