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It was a long time ago, so I'm operating off questionable memory here, but IIRC the major tell was looking at patient longevity (questionable hospices had longer patient tenure, presumably because of more aggressive recruitment of non-EOL pts) and distribution of inpatient care days (which have the highest reimbursement rate, so questionable hospices tended to max out inpatient days). There was definitely a correlation between size of hospice and those variables, and hospices involved in DOJ/HHS prosecutions were correlated with longer pt tenure and high utilization of inpatient care.

Your work sounds interesting and enlightening -- I'm not familiar with dialysis facilities clinically or from a business PoV, but I'm curious if they suffer from some of the same incentives issues as hospices, given the significant Medicare/Medicaid spend in that area, and the number of ESRD policy carve-outs.




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