Dying or Lying? For-Profit Hospices and End-of-Life Care

• 成果类型: Article
• 署名作者: Gruber, Jonathan; Howard, David h.; Leder-luis, Jetson; Caputi, Theodore l.
• 署名单位: Massachusetts Institute of Technology (MIT); National Bureau of Economic Research; Emory University; Boston University
• 刊物名称: AMERICAN ECONOMIC REVIEW
• ISSN/ISSBN: 0002-8282
• DOI: 10.1257/aer.20230328
• 发表日期: 2025
• 页码: 263-294
• 关键词: FALSE CLAIMS ACT; Medical expenditures; COMMON OWNERSHIP; nonprofit; liability; QUALITY; length; death

摘要

The Medicare hospice program is intended to provide palliative care to terminal patients, but patients with long stays in hospice are highly profitable, motivating concerns about overuse among the Alzheimer's and Dementia ( ADRD ) population in the rapidly growing for-profit sector. We provide the first causal estimates of the effect of for-profit hospice on patient spending using the entry of for-profit hospices over 20 years. We find hospice has saved money for Medicare by offsetting other expensive care among ADRD patients. As a result, policies limiting hospice use including revenue caps and antifraud lawsuits are distortionary and deter potentially cost-saving admissions. ( JEL H51, I11, I12, I18, J14, L84)