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 aren’t 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 ...
My mother was in hospice when she died here in our home. Thank God for them, they were a blessing.
Uh why would a person want a catheter if they didn’t need it? No resale value as such either. Oh BTW the user has to be {sized} fitted for the right size. That said I think the cost is too high for such items but it’s been so for decades. The mail order places thrive because in most towns there is no other means to get the supplies.
Okay....you win....I’m done here. No fraud, no needless expense.
Hospice isn’t the issue. The issue is fraud.
I can’t believe these liberals are advocating removing humane end of life care.
I'm not saying their isn't fraud. But in Home Health it would not be as easy as you think. I'm a caregiver of 28 years. True things may vary state to state {which would actually be Medicaid} but for the most part a lot of stuff is hard to get approved.
Case in point. My wife is a quadriplegic. We have been fighting a pressure sore for nine months. She needs a special mattress called a Low Air Pressure Release I think is the type. It is for persons who are highly prone to pressure sores. We're still fighting to get it paid for. Here is where initial cost vs future cost factors in. I'm guessing about $12K has been paid out just for this sore. Why not a $1000 mattress to prevent more $15K expenses in the future? The sore wasn't that big initially until she was placed on a cheaper air mattress as hard as river rocks not meant for quads. BTW four of her doctors say she need the one we are trying to get approved.
I'm also a former nursing home employee so I know quite a bit on waste there as well.
I have no doubt at all there are cases like yours that are legitimate. My cousin was a quad and he had the special air mattress that cycled different pressure points every 5 minutes.
By and large, though, situations like yours are not the real problem. It is the other more prevalent examples that compound the problem immensely.
Both these were guys that were getting around fine before the meds....no shortage of breath,,,not overweight... The tests....everything is the tests.
Another friend stopped his meds...said he had things wrong with him that he never had wrong with him before taking the meds. He's alive and well...and 82.
A couple years ago my dad was on Home Hospice for cancer. They came out first time Mom told them to leave. Mom wasn't privy to fact the doctor gave him less than six months four months earlier. The second time after dad told her it went a lot easier. They said this is a six month enrollment. If your life is longer we can extend the enrollment or if your prognoses changes we will re-evaluate you being in the program.
They basically told us we are here to make you as comfortable as possibe but end life prolonging treatments. He had advanced Prostate Cancer. They kept him on needed pain meds actually a fraction of what dosage he was talking before with Chemo and it worked. They came by every other day, meds came to the house, they were on call 24/7 for help. I was the primary caregiver as I had the knowledge for it. He passed about a month later.
Opps... Tagline corection. LOL
I had an aunt that legitimately had fatal cancer. However, she lasted damn near a decade with the slow progression.
She ended up with an oncologist that killed her in a matter of months. I truly believe he’d have killed her long before that if she’d gone to him earlier on.
One might say that if she’d seen him earlier, he’d have had a better success rate. I maintain, however, he was a cold blooded bastard more interested in rote application of barbaric treatment without human regard for the effects.
Frankly, I’d rather have a decade of slow progressive death than two or three years of aggressive, impersonal and careless extraction of money from my wallet or insurance account.
Interesting thread. How much money taken from your pay has been poured down the “healthcare” rathole. Accountability for your own health? Your own care? Examining finances for competing services and doctors fees ? Examining billing to make sure you get what you paid for? Are the services/equipment/tests really needed? Are health savings accounts encouraged?
How did we get to a $22 trillion prescription drug liability and an $88 trillion medicare liability?
Who FORCED this on us?
Physical health, mental health, financial health RESPONSIBILITY BUMP!
This is what the whole “Right to Die” movement really was all about...it really was about “Duty to Die.”
Hospice saves Medicare a great deal of money. It allows us to care for terminal patients in their home setting without several admissions to the hospital for pain or symptom control. Hospice care is a marvous thing in the right patient. Once we stop aggressive care and focus on symptom control patients blossom and often feel much better. Patients and families are given the gift of pleasant time at home rather than spending the last days/weeks with their loved ones sitting in a hospital
So, if you are in the profession, can you tell me the percentage of costs and usage with respect to ‘in home’ and ‘in facility’ categories?
Personally I believe if a person at home {family member} has the disposition to be a caregiver at home care is cheaper, healthier, and safer.
Medicare wise the number of Home Health visits is limited I think to a dozen a year whereas Hospice is unlimited. Cost of Home Health vs Nursing Home care is a no brainer. Home Health is a fraction of the cost. Still some things make it an impossibility like Dementia. It's not really wise or safe to do home care unless you have 24/7 on sight wide awake help.
FWIW, a neighbor in his 90s was dying in the hospital, going through all kinds of medical treatments and drugs. His family (a wife in her 90s and a daughter in her 60s) took him home "to die" but needed someone from hospice about an hour a day to help.
He gave up doctors, medications, treatments, all of it. He got somewhat better, became more coherent, and lived almost two years more.
What's my point? In some cases hospice is expensive because people the hospitals, drugs and doctors would've killed actually live longer.
I do t know the percentages. I work only with hospitalized patients. But cost wise home care is greatly less expensive. More importantly patients get to spend their final days At home surrounded by their families not in the hospital with strangers poking at them drawing blood and doing uncomfortable tests and treatments
Don’t do hospice......path to death. Let yourself die naturally. Offer up the pain.
You can do a lot of home are for the price of one hospitalization. But the rewarding part of hospice is seeing the patients blossom when we can finally make them comfortable and treat symptoms instead of trying to prolong life no matter how miserable it makes them. Also hospice patients are no longer on chemo or other expensive treatments so I do t see any way hospice can cost more even. If the patient lives weeks and months longer
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