Jake Johnson writes for Common Dreams about a new report from the Private Equity Stakeholder Project that focuses on private equity’s “disastrous” hold on home health care and hospice care. Vulnerable older adults and people with disabilities are paying a high price, as is the Medicare program. Congress is sitting back and watching.
Non-profit agencies once provided most home health and hospice services. Today, for-profit companies have taken over the majority of these two industries. Two in three hospices are for-profit and two in five home health care agencies are for-profit. Private equity has invested heavily in the corporations that own these agencies.
Medicare home health care and hospice care can be good money for corporations, so long as care is limited and low-cost. So, they are likely working to get more people to take advantage of these benefits. More Medicare investment in this care would be wonderful–many people who would benefit from this coverage are unaware they are eligible for it–if the money is being spent wisely and being directed towards more people with Medicare who want and need these benefits.
But, if private equity investment in nursing homes and PACE programs is any indication, people are getting far lower quality hospice and home health care from companies with private equity backing, and Medicare is spending more than it should for their care. Private equity ownership of nursing homes is associated with poorer care and more deaths. The home health and hospice industries are even less regulated than nursing homes.
With private equity, profits come first. The cost to vulnerable older adults and people with disabilities receiving care from private-equity backed companies is likely high but hard to measure. In a 2021 Congressional hearing on private-equity owned nursing homes, Congressman Bill Pascrell of New Jersey asked, “How many grandmothers and grandfathers died because profits were prized above lives, with our taxpayer dollars funding this?”
So, are any private-equity owned hospice agencies delivering quality care and not driving up Medicare spending needlessly? As with Medicare Advantage plans, we do not have good agency-specific information. The Private Equity Stakeholder Project report concludes, more generally: “Unfortunately, for-profit home healthcare and hospice companies have been linked to lower standards of care compared to their non-profit counterparts, including, but not limited to, a lower number of visits to patients by healthcare professionals (registered nurses, physicians, or nurse practitioners) in their final days in hospice, higher rates of hospitalization in home healthcare, and poorly paid—yet highly stressed—employees in both sectors.” “This is additionally troubling, because such for-profit entities serve higher percentages of people of color and those with low incomes.”
Congress needs to start paying attention. Already a number of home health and hospice agencies have been charged with overbilling Medicare, underpaying their workers and neglecting patient care needs. For example, there are allegations that Kohlberg Kravis-owned BrightSpring, a home health care agency, put patients at risk, and other private-equity backed agencies have been charged with fraudulent billing of Medicare and Medicaid.
In October of last year, Senator Elizabeth Warren reintroduced the Stop Wall Street Looting Act to stop private equity’s “predatory” and “abusive” practices, but that bill is going nowhere at the moment.
Here’s more from Just Care:
- Don’t trust Medicare nursing home star ratings
- Need home health care? Don’t count on Medicare
- Medicare hospice benefit has become a luxury
- Take advantage of Medicare’s annual wellness visit
- FDA is hiding information on supplements that are dangerous
