In:
Medical Care, Ovid Technologies (Wolters Kluwer Health), Vol. 58, No. 4 ( 2020-04), p. 329-335
Abstract:
In recent years, policymakers have paid particular attention to the emergence of a robust for-profit hospice sector and increased hospice use by nursing home residents. Previous research has explored financial incentives for nursing home-hospice use, but there has been limited research on nursing home-hospice partnerships and none on the extent of nursing home-hospice common ownership. Objective: To describe trends in nursing home-hospice contracting and common ownership and to identify potential tradeoffs in care provided by nursing homes and hospice agencies that share common ownership. Research Design: Retrospective cohort study of nursing home-hospice patients between 2005 and 2015. Results: Between 2005 and 2015, the number of hospice agencies and nursing homes with common ownership grew substantially, now representing almost 1-in-5 providers in each sector. Relative to individuals using hospice in nursing homes without common ownership, adjusted analyses found that individuals receiving hospice from a commonly owned agency had a greater likelihood of having stays of 90 days or more [odds ratio (OR)=1.06; 95% confidence interval (CI), 1.02–1.10], having a stay resulting in a live discharge (OR=1.06; 95% CI, 1.02–1.11), and having at least 1 registered nurse/licensed practical nurse visit during the last 3 days of life (OR=1.17; 95% CI, 1.05–1.29); these individuals also had a lower mean visit hours per day (−0.07; P =0.003). Conclusions: Common ownership between hospice agencies and nursing homes is an emerging trend that reflects a broader push toward consolidation in the health care sector. Our analyses highlight potential concerns relevant to Medicare payment policy and are a first step toward improving our understanding of these trends and their implications.
Type of Medium:
Online Resource
ISSN:
0025-7079
DOI:
10.1097/MLR.0000000000001289
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2020
detail.hit.zdb_id:
411646-X
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