Track
Track 1: Technology, Data & Institutional Transformation
Publication Date (MM-DD-YYYY)
3-7-2026
Start Date (MM-DD-YYYY)
3-7-2026 2:15 PM
End Date (MM-DD-YYYY)
3-7-2026 2:45 PM
Presentation Type
Presentation
Description
The landscape of hospice ownership has undergone a dramatic shift over the past two decades (2005-2014 and 2015-2025). Historically, hospice has been chiefly profitable as an industry comprising not-for-profit agencies. From 2015-2016, private equity entities have increasingly impacted for-profit ownership, which now owns approximately 12% of hospice agencies. This trend has raised concerns that private equity entities' emphasis on short-term profitability may reduce the quality of hospice care and services, potentially affecting end-of-life care. The aim of the research is to examine how hospice ownership status, patients’ primary hospice diagnosis, and the setting of hospice care predict three measures of hospice quality: (a) the average number of visits per patient-day by hospice professionals in the last 30 days of life (calculated at the patient level by computing the average number of visits per day for each patient during their length of stay in hospice), (b) the duration of bedside care provided by these professionals, and (c) the proportion of patients who received hospice visits from a registered nurse or medical social worker on at least two of the final three days of life (HVLDL).
The research will be quantitative and use logistic regression to evaluate hospice ownership status, patients’ primary diagnosis, and how the setting of hospice care predicts three measures of hospice quality. The research participants will be comprised of all United States Medicare beneficiaries who enrolled in hospice care and died during a hospice admission between 2018 to 2019 and 2022 to 2023. This study will evaluate hospice quality by assessing the extent to which hospice ownership, the patient's primary diagnosis, and the setting of care may predict care and quality measures of frequency and duration of professional visits to hospice enrollees and HVLDL.
Recommended Citation
(2026). Hospice ownership & quality metrics (analytics & policy link). Retrieved from https://fuse.franklin.edu/dsa-conf/2026/presentations/6
Hospice ownership & quality metrics (analytics & policy link)
The landscape of hospice ownership has undergone a dramatic shift over the past two decades (2005-2014 and 2015-2025). Historically, hospice has been chiefly profitable as an industry comprising not-for-profit agencies. From 2015-2016, private equity entities have increasingly impacted for-profit ownership, which now owns approximately 12% of hospice agencies. This trend has raised concerns that private equity entities' emphasis on short-term profitability may reduce the quality of hospice care and services, potentially affecting end-of-life care. The aim of the research is to examine how hospice ownership status, patients’ primary hospice diagnosis, and the setting of hospice care predict three measures of hospice quality: (a) the average number of visits per patient-day by hospice professionals in the last 30 days of life (calculated at the patient level by computing the average number of visits per day for each patient during their length of stay in hospice), (b) the duration of bedside care provided by these professionals, and (c) the proportion of patients who received hospice visits from a registered nurse or medical social worker on at least two of the final three days of life (HVLDL).
The research will be quantitative and use logistic regression to evaluate hospice ownership status, patients’ primary diagnosis, and how the setting of hospice care predicts three measures of hospice quality. The research participants will be comprised of all United States Medicare beneficiaries who enrolled in hospice care and died during a hospice admission between 2018 to 2019 and 2022 to 2023. This study will evaluate hospice quality by assessing the extent to which hospice ownership, the patient's primary diagnosis, and the setting of care may predict care and quality measures of frequency and duration of professional visits to hospice enrollees and HVLDL.
