Government efforts to improve quality, fight fraud, and stop profiteering in the hospice industry are partly responsible for a record wave of mergers and acquisitions that hedge against a new Medicare payment system. From a handful of small nonprofit organizations in the 1970s, hospice end-of-life care has grown into a thriving $19 billion a year industry led mainly by for-profit, investor-owned companies. Medicare is the nation’s largest payer for hospice care, covering more than 90% of patient stays in 2018 on behalf of more than 1.5 million beneficiaries. Use of the Medicare hospice benefit will grow as millions of aging baby boomers require end-of-life care in the coming years.
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