Nonprofit or For-Profit Hospice – Is There a Difference?
Lower Cape Fear LifeCare (formerly Lower Cape Fear Hospice) is a nonprofit hospice that was founded almost 40 years ago by community volunteers to meet the needs of patients with life-limiting illnesses and their families. Much about hospice care has changed since then. This specialized medical care is more readily available, and such care at end of life is more widely accepted by patients and families.
With the growth of hospice care came an insurgence of for-profit providers. That’s because in 1986 (six years after Lower Cape Fear LifeCare was founded), the Medicare Hospice Benefit was made permanent. The Medicare reimbursement rate is the same for each patient, no matter the level of care needed to manage pain or symptoms. It also allows for reimbursement for all medications and supplies.
Research published in the Journal of the American Medical Association (JAMA) and the International Journal of Health Care Finance and Economics finds that for-profit hospices tend to target patients who need less intensive care for longer periods of time, such as dementia patients and those in assisted living facilities. Nonprofit hospices treat everyone and therefore serve mostly patients with illnesses requiring higher levels of care for shorter periods of time, such as cancer patients. For-profits were three times more likely to exceed Medicare’s aggregate annual cap and had a lower percentage of patients that stayed under their care until death.
Nonprofits, such as Lower Cape Fear LifeCare, use donations and monies raised through fundraising events to ensure they are able to provide indigent care; extensive grief care services, including specific children’s grief programs; special recognition of veterans; fulfillment of bucket-list wishes; education opportunities for caregivers and the public; and much more. For them, the care and support of those in the community is heavily embedded in their mission.
Although both nonprofits and for-profits provide patients and families with an interdisciplinary team which provides pain management and symptom relief, there are still differences to consider when choosing a hospice provider.
- Spend 25 percent more on comprehensive care per patient
- Provide more in-home care than for-profits
- Discharge patients before dying at a lower percentage rate than for-profits
- Have 50 percent fewer re-admissions for hospital care than for-profits
- Admit higher-cost and higher-acuity patients than for-profits
- Admit all patients with a terminal illness, seven days a week
- Provide no-cost grief care services accessible to everyone in the community; for-profits provide little or contract out bereavement services for families.
- Invest dollars in clinical education to enhance care (many of LCFL’s clinicians have earned specialized certifications in hospice and palliative care) and offer additional therapeutic treatments.
Even more differences may include the amount of volunteer support available, the variety and amount of bereavement offerings, and the number of public and provider educational programs offered. Nonprofits also tend to have strong ties to the communities in which they provide care and services.
It’s important to note that Lower Cape Fear LifeCare never denies care based on someone’s ability to pay.
We also operate three inpatient hospice care centers that are available when pain and symptoms cannot be managed in a home setting, thereby providing a continuum of care that no other hospice in our region can match.
Regardless of nonprofit or for-profit status, Medicare provides a way for patients and families to directly compare hospice providers on their Hospice Compare website. Ratings are based on the opinions and experiences of caregivers and will give you an idea of how each provider ranks in multiple categories, including willingness to recommend, responsiveness, communication with family, dignity provided to patients, spiritual care, and more.
When choosing a hospice provider, ultimately, the choice is yours. Be Informed. Know your options for care.
To find out more about what to look for in a provider and the benefits of getting hospice care sooner, read Don’t Wait – Hospice Provides Months of Care and Support.
Since 1980, Lower Cape Fear LifeCare (formerly Lower Cape Fear Hospice) has served patients and their families throughout southeastern North Carolina, serving patients where they live – in their homes, hospitals, assisted living and skilled nursing facilities. For more information on how to start the conversation about hospice, please call 800.207.6908.