U.S. Sens. Ron Wyden (D-OR), Sherrod Brown (D-OH), and Elizabeth Warren (D-MA) launched an investigation into private equity ownership of for-profit hospice companies.
Specifically, the investigation focuses on Kindred at Home during the period when the company was purchased and owned by Humana and two private equity firms, TPG Capital and Welsh, Carson, Anderson & Stowe.
“We are concerned that when applied to hospice care, the private equity model of generating profit on a rapid turnaround can occur at the expense of dying patients and their families,” the senators wrote in a letter to the president and CEO of Kindred at Home David Causby. “Since its inception as a small volunteer-run movement in the 1960s, the hospice industry has transformed into a $20 billion industry with a marked increase in for-profit ownership. There is evidence that care quality is lower in for-profit hospice companies, making these ownership trends in the hospice industry a cause for concern.”
According to 2017 data, more than two-thirds of hospice providers were for-profit, compared with less than a third in 2000. During that time, according to Medicare Payment Advisory Commission, the number of hospices overall doubled, with for-profit hospices accounted for most of the net increase.
A recent report by the Government Accountability Office (GAO) found that hospices with the lowest quality scores are most likely to be for-profit. Further, the senators stated that for-profit hospices are more likely than non-profit hospices to have low rates of home visits in the last days of life and high rates of live discharge from hospice.
The senators are requesting data on a range of quality indicators at Kindred at Home over time. They are also looking for information about private equity ownership and activities between 2017 and 2021 when the company was purchased by Humana and the two private equity firms.