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For-profit vs. not-for-profit: Is one better than the other?

Cherry picking" was the term used in an Associated Press headline for an article that described the results of a Journal of the American Medical Association article comparing diagnoses, length of stay, and patient care between not-for-profit and for-profit hospices.

Disease-specific programs enhance care

Developing a business model or marketing strategy that includes services focused on specific patient populations does not necessarily mean that a hospice is targeting higher revenue patients as implied in a study recently published in the Journal of the American Medical Association,

Focus on quality, not tax status

Outcomes mean more to patients

Headlines comparing the level of care provided by not-for-profit vs. for-profit hospices did not produce a flood of calls to local hospices questioning their quality of care, but it did create some conversations.

The best way to respond to questions from board members or community members who raise questions about quality and tax status is to point out that quality is measured by outcomes, not tax status, says Joan M. Teno, MD, MS, professor of community health and medicine at the Warren Alpert School of Medicine of Brown University and associate medical director for Home and Hospice Care of Rhode Island, a not-for-profit hospice in Providence, RI. Hospices are measuring outcomes now in preparation for public reporting of quality so a more accurate comparison of all hospices can be made, she says. "I don't have a crystal ball but I image we'll see opportunities for improvement in outcomes for not-for-profit and for-profit hospices once we have the ability to see those results."

"We discussed the study and its implications in our administrative staff meeting," says Mark M. Murray, president and chief executive officer of The Center for Hospice Care, a not-for-profit hospice in Mishawaka, IN. "The story wasn't picked up in the local media so we talked about how to handle the conversation if someone brought it up, but we did not take proactive steps to address it in the media or with our staff," he says. "Why create an issue where there is none?"

"I'm not sure the public cares about tax status if your hospice provides the care a patient and family need," says Murray. One of the questions asked of focus groups conducted by Murray's hospice in preparation of a marketing program was "Does it matter to you if the hospice is not-for-profit or for-profit?" "Forty-five percent of the focus group participants said it did not matter or they didn't know if it would matter."

Although the general public may not care, the real concern is that the study will be read by the Medicare Advisory Payment Committee, says J. Brad Hunter, chief executive officer of Legacy Hospice, a for-profit hospice in Charlottesville, VA. "For those of us who are for-profit hospices to select only specific patients based on revenue, we'd have to ignore physician referrals as well as the Medicare Conditions of Participation (COPs)," he says. "If we ignore referrals and COPs we won't continue getting referrals or reimbursement from Medicare!"

CMs guide seniors through EOL processes

Seniors covered by BlueCross BlueShield of Tennessee's Medicare Advantage plan are guided through the end-of-life processes by case managers (CMs) who empower the members with the education, resources, and assistance they need to make their own decisions about what kind of care they want to receive at the end of life.

Ethics committee debates end-of-life treatment

As hospitals add more palliative care services, ethical issues arise that sometimes cannot be handled solely by a hospital ethics board because a broader community perspective is necessary.

Educating hospital staff about palliative care

Palliative care once was a rare treatment option in the hospital setting, but in recent years it has grown in popularity to the point that most major hospitals and many small-to-mid-sized hospitals have palliative care programs available for patients, an expert says.

ED focuses on caring for end-of-life patients

An ED program designed to serve the terminally ill? It makes perfect sense to Mark Rosenberg, DO, MBA, FACEP, chairman of emergency medicine at St. Joseph's Regional Medical Center in Paterson, NJ. So much so, in fact, that his department recently introduced Life-Sustaining Management and Alternative (LSMA) services. The program is designed to provide comfort, control, and choices for chronic and terminally ill patients and their loved ones.

Walking competitions keep staff happy

This is the second of a two-part series that examines ways to support employees in their personal lives in order to improve work performance and staff retention. Last month we looked at the use of Employee Assistance Programs (EAPs) and offered suggestions for choosing the right provider for your hospice. This month, we learn about a hospice that has set up an in-house wellness program that addresses personal life issues for employees.

Hospice Management Advisor Archives – April 1, 2011

April 1, 2011