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Dying or Lying? For-Profit Hospices and End of Life Care
Jonathan Gruber
David H. Howard
Jetson Leder-Luis
Theodore L. Caputi
American Economic Review (Forthcoming)
Abstract
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 twenty 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 anti-fraud lawsuits are
distortionary and deter potentially cost-saving admissions.