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Hospice Care Needs a Makeover

Some Chicago physicians are working with advocates and hospice providers to develop new models to improve care by Bonnie Miller Rubin

IN 2021, more than 1.6 million Americans chose hospice for their end-of-life care—and many families are grateful for the experience, saying it allows their loved ones to remain at home, relieves suffering and promotes a “good death.”

However, in recent years, what was once considered a “calling” has turned into a lucrative $24 billion industry and the most profitable of all Medicare services. The explosive growth has been fueled by an aging population, generous Medicare payments and lax oversight, which critics say fails patients at the most vulnerable time of their lives, critics say.

“There’s been a system failure,” said Logan Hoover, a vice president of the National Hospice and Palliative Care Organization (NHPCO), which represents some 6,000 Medicare-certified hospice agencies nationwide. “It’s incumbent on all of us to take a step back, look at our roles and see where we can do better.”

This call to action was sparked by a 2022 investigation by ProPublica and the New Yorker magazine, which shed light on a healthcare sector plagued by profiteering and an increasing number of “bad actors,” according to interviews with a dozen physicians, nurses and administrators.


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