Removing review of R.I.’s hospice providers poses a threat to patient care

The CON process isn’t one of the flashier, public-facing functions of state government, but it has a direct impact on the quality of health and hospice care that Rhode Islanders receive throughout their lives.

The CON process is used to determine the need for a particular health care service and to ensure that providers entering Rhode Island are prepared and equipped to provide the highest quality, most ethical care before receiving a license.

Exempting hospice from meeting the rigorous standards that a CON requires poses an immediate threat to the quality of patient care.

In fact, extensive reporting from ProPublica found that states without CON requirements experienced significant problems with fraudulent, bad-faith hospice care providers.

In the last decade, profit-driven private equity firms have spent more than $1 trillion on health care acquisitions — and now they have their sights set on hospice care. A recent study found that for-profit, private equity hospices are more likely to discharge patients from hospice, meaning these patients were not eligible for hospice in the first place and the private equity hospice was still getting paid. In addition, these hospices are more likely to transfer patients to hospitals and emergency rooms and have higher rates of complaints and deficiencies.

Recently, based on increased reports of hospice fraud, waste and abuse, the Centers for Medicare and Medicaid Services (CMS) announced enhanced oversight for new hospice providers in Arizona, California, Nevada, and Texas. It’s not a coincidence that none of these states require a CON for hospice care.

All of this is a warning for Rhode Island. To roll back Certificate of Need requirements for hospice providers exposes vulnerable Rhode Islanders to the whims of anonymous, for-profit operators who put profit first, and patient care a distant second. Research has demonstrated that states with CON requirements have much higher quality of hospice care.

When we opened in 1976, HopeHealth was only the second hospice in the United States. As the leader of this nonprofit organization, I can tell you that this work is not about maximizing profits. It’s a calling.

On behalf of our patients, their families, and our employees, we strongly urge the General Assembly not to weaken Rhode Island’s Certificate of Need process. Instead, we should recommit to maintaining the high-quality hospice system that provides a level of care that Rhode Islanders have come to expect — and deserve — from their hospice providers by keeping hospice in CON.

Diana Franchitto is the president and CEO of HopeHealth Hospice & Palliative Care.