Hospice is medical care for those near the end of life who have a terminal illness with a life expectancy of six months or less to live.  Hospice offers support for the person affected as well as their family through spiritual, social, physical, and psychological services.  The number of for-profit hospices has been rapidly increasing over the years. In 2017 100% of new hospices were for-profit and in 2022 70% of all hospice agencies were for-profit.

Assembly bill A8472 was introduced to prohibit the establishment of any new for-profit hospices in NYS.  So why does it matter if a hospice is for-profit or not? 

Well, to begin it doesn’t take critical thinking skills to realize that for-profit businesses will only increase in numbers if they see a clear profit in a given market.  And as of this year, for-profit hospices are seeing this market turn into a 20 billion-dollar industry. 

Profit means that instead of having a singular goal of providing hospice care, a for-profit entity will have a duo goal of not only providing hospice care but also demonstrating a return on investment for its stakeholders.  This means the care and services needed may be compromised in order to craft better numbers. And with oversight of the system being monitored infrequently at best, it allows for abuses that may go unnoticed if not for select whistle-blowers. 

In fact in 2016 data indicated that the majority of all hospices were running at less than peak or even acceptable levels with little more than a slap on the wrist, and without being denied future Medicare funding, when discovered for their actions.  Also, the people who are running the hospice may not have a medical degree as some owners are accountants or attorneys. And the types of patients they admit may also be skewed. Cancer patients were more likely to be accepted into hospice because their expected life expectancy was more predictable then dementia patients. It also may mean a larger drain on Medicare as it has been shown that for-profit hospices are three times more likely to exceed the maximum benefit allowed by Medicare thereby passing the costs onto the family.  Unfortunately, this results in more people leaving hospice care before death because of the financial burden.