NPHI Applauds the Senate Finance Committee for Opening Inquiry into the Impacts of Private Equity Investment in the Hospice Industry

NPHI Applauds the Senate Finance Committee for Opening Inquiry into the Impacts of Private Equity Investment in the Hospice Industry

WASHINGTON, DC, August 10, 2021 // Today, the National Partnership for Healthcare and Hospice Innovation (NPHI) declared its support for a recently announced Senate Finance Committee investigation, led by Chairmen Ron Wyden (D-OR), Elizabeth Warren (D-MA), and Sherrod Brown (D-OH), into the impacts of private equity investment in the hospice industry and resulting reductions in quality of care for Medicare beneficiaries. Specifically, the investigation focuses on Kindred at Home and their history of private equity-driven growth.

NPHI joins the Senate Finance Committee in being troubled by the dramatic rise of new entrants into the hospice industry – a growth almost entirely driven by for-profit providers. Moreover, NPHI is pleased that the Committee has taken note of evidence suggesting that hospices with the lowest quality scores are most likely to be for-profit in nature. These providers display an apparent disregard for the original intent of the Medicare hospice benefit in favor of an increasingly profit-driven approach that is incompatible with the purpose of end-of-life health care. Like the Committee, we find this to be an unacceptable option for patients and their families as they experience the tragedy of losing a loved one.

“It will come as no surprise to those with personal hospice experiences that the best care is provided by those focused on patients and not profits,” said Tom Koutsoumpas, CEO of NPHI. “That is why the $20 billion for-profit hospice industry and the declining quality outcomes associated with these providers is so worrisome. NPHI believes the data clearly indicates that these trends are negatively impacting patients and are worthy of both careful examination and appropriate condemnation.”

NPHI’s community-based, mission driven members know that the highest-quality care is delivered by those organizations focused on meeting patient needs at whatever the cost rather than making decisions solely based on increasing their profit margins. Consequently, we are proud to represent the non-profit hospice and palliative care community at large, who primarily serve as safety-net providers offering end- of-life care to the sickest and most vulnerable patients. To this end, NPHI recently commissioned a study by the actuarial and accounting firm Milliman1, to document the specific characteristics and differences between our non-profit members and other providers.

Among other findings, the report determined that:

  • Non-profit hospices had an aggregate net Medicare margin of 3.0%, compared to nearly 20% at for-profit
  • The most common diagnosis category of non-profit hospice patients was cancer (31% of patients at non-profit hospices versus 22% of patient at for-profit hospices), while the most common diagnosis category of for-profit hospice patients was degenerative diseases such as dementia (15% of patients at non-profit hospices versus 22% of patients at for-profit hospices).
  • Patients who were live discharged from for-profit hospices incurred 40% higher daily Medicare Part A costs in the first two weeks post-discharge than patients who were live discharged from not- for-profit

NPHI looks forward to serving as a resource for the Committee and continuing to educate policymakers on the key differences between hospices driven by a focus on patient care rather than profits. Most importantly, we appreciate the Committee’s dedication to ensuring that individuals receive the highest quality, patient-centered care at the end-of-life and are devoted to safeguarding the Medicare hospice benefit as a set of services that does just that.


Press Contact: Rachel Jordan, Communications, National Partnership for Healthcare and Hospice Innovation, 732-406-8877

The National Partnership for Healthcare and Hospice Innovation (NPHI) is a collaborative of 75+ not-for-profit, community-integrated hospice and palliative care providers dedicated to ensuring patients and their families have access to care that reflects their individual goals, values and preferences. Representing providers from 31 states and the District of Columbia, NPHI and its members help design more innovative and effective models of care, advocate for comprehensive and community-integrated care customized to meet each person’s unique needs, and build collaboration between national thought leaders, decision-makers, and other healthcare stakeholders to improve hospice care. Learn more about NPHI at