Family caregivers say they have worse care experiences at for-profit hospices than at not-for-profit hospices, a new journal article found.
 
Earlier research has shown that for-profit hospices do not perform as well as not-for-profit hospices, with higher rates of hospitalizations and emergency department visits, as well as offering a narrower range of services such as less nursing visits. The percentage of hospices that are for-profit has risen significantly over the past two decades, increasing from 30% in 2000 to 73% in 2020, according to the Medicare Payment Advisory Commission.
 
The new research article, which was published today by JAMA Internal Medicine, examines Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Survey data collected from 1,761 for-profit hospices and 906 not-for-profit hospices.
 
The CAHPS Hospice Survey includes eight measures of hospice care experiences by family caregivers: hospice team communication, getting timely care, treating family member with respect, getting emotional and religious support, getting help for symptoms, getting hospice care training, rating of hospice, and willingness to recommend a hospice. The CAHPS Hospice Survey also includes a summary measure, which is an average of a hospice's performance across the eight measures of hospice care experiences.
 
CAHPS Hospice Survey data was examined from April 2017 to March 2019.
 
The new research article includes four key findings:
  • For all measures, family caregivers reported worse care experiences at for-profit hospices than at not-for-profit hospices
  • For-profit hospice performance varied, with 31.1% of for-profit hospices scoring 3 or more points below the national hospice average of overall performance, and 21.9% scoring 3 or more points above the national average
  • Not-for-profit hospices scored better on overall performance, with 12.5% of not-for-profit hospices scoring 3 or more points below the national average, and 33.7% of not-for-profit hospices scoring 3 or more points above the national average
  • Family caregivers with patients who received care in for-profit state, regional, or national hospice chains reported the worst care experiences