Wyden, Brown, Warren Probe Private Equity Ownership of Kindred at Home

Letter to Kindred at Home Highlights Rapid Growth and Lower Quality of For-Profit Hospice Companies

Washington, D.C. – Senate Finance Committee Chairman Ron Wyden, D-Ore., and Senators Sherrod Brown, D-Ohio, and Elizabeth Warren, D-Mass., today launched an investigation into private equity ownership of for-profit hospice companies and subsequent reductions in the quality of care. The investigation centers on Kindred at Home and the period where the company was purchased and owned by Humana and two private equity firms, TPG Capital and Welsh, Carson, Anderson & Stowe.

“We are concerned that when applied to hospice care, the private equity model of generating profit on a rapid turnaround can occur at the expense of dying patients and their families,” the senators wrote. “Since its inception as a small volunteer-run movement in the 1960s, the hospice industry has transformed into a $20 billion industry with a marked increase in for-profit ownership. There is evidence that care quality is lower in for-profit hospice companies, making these ownership trends in the hospice industry a cause for concern.”

In 2017, more than two-thirds of hospice providers were for-profit, compared with less than a third in 2000. According to the Medicare Payment Advisory Commission (MedPAC), “the number of hospices doubled from about 2,300 to nearly 4,500 from 2000 through 2017, and for-profit hospices accounted for the entirety of the net increase during that time period.”

A recent report from the Government Accountability Office (GAO) found that hospices with the lowest quality scores are most likely to be for-profit. For-profit hospices are more likely than their non-profit counterparts to have low rates of home visits in the last days of life and high rates of live discharge from hospice, both important quality measures. GAO found that non-profit hospices had slightly higher percentages of white beneficiaries, and for-profit hospices had a greater proportion of patients enrolled in both Medicare and Medicaid,” indicating that for-profit hospices are more likely to serve patients of color and low-income patients.

The letter requests data on a range of quality indicators at Kindred at Home over time, and information about private equity ownership and activities between 2017 and 2021, when the company was purchased and owned by Humana and two private equity firms, TPG Capital and Welsh, Carson, Anderson & Stowe.

The full letter is here.

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Letter to Kindred at Home Highlights Rapid Growth and Lower Quality of For-Profit Hospice Companies

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