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View Diary: Medicare: What can we do about it? (314 comments)

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  •  Then why so many nursing home patients? (0+ / 0-)

    When I visit nursing homes staff does not appear to be greater than patients by a long shot.
    Hospice must be more expensive than nursing home for Medicare? What am I missing?

    •  Hospice requires near death diagnosis (2+ / 0-)
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      Notreadytobenice, tardis10

      Most in nursing homes are not expected to die within 6 months. But actually the cost benefit comparison for hospice is to hospital care, which is the typical alternative at the very end of life.

      A good article about hospice here  Note that the issue of for-profit providers is now raising its ugly head in that arena as well.

      Hospice care has become a complex issue, and the recent explosion in the number of for-profit hospices has set the stage for debate about how to best care for individuals at the end of life in terms of both quality of life and cost effectiveness. Passionate proponents of mission-driven hospices argue that the tax status of a hospice can influence the services provided because of differences in priorities (ie, shareholders v patients). For-profit hospices argue that their tax status allows better access to capital to enhance care. That theory has led several nonprofit hospices to change their tax status.

      Several questions have been raised during this recent debate. Has the philosophy of hospice changed? Has tax status affected the quality of hospice? Are the economic incentives driving patient selection by hospice providers fair? Do patients enrolled in hospice receive the care that meets their needs? A review of the history of hospice and emerging trends in its use and practices may provide some answers.

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