Hospices Have Financial Incentives to Target Assisted-Living Residents, OIG Says

Hospices have financial incentives to target beneficiaries in assisted-living facilities (ALFs) because they may offer the hospices the greatest financial gain, states a January 13, 2015, report from the U.S. Department of Health and Human Services' Office of Inspector General (OIG). OIG analyzed all Medicare hospice claims from 2007 through 2012, finding that Medicare payments for hospice care in ALFs more than doubled in five years, totaling $2.1 billion in 2012. Hospices provided care much longer and received much higher Medicare payments for beneficiaries in ALFs than for beneficiaries in other settings. Hospice beneficiaries in ALFs often had diagnoses that typically require less complex care.