[UPDATED] Citing Competition and Consumer-Protection Concerns, CMS Makes Hospice-Ownership Data Publicly Available

In what the agency is calling an effort to promote industry competition and protect consumers, the U.S. Department of Health and Human Services (HHS) is making hospice-ownership data publicly available.

HHS is also releasing ownership data for all Medicare-certified home health agencies, the department specified in a Thursday announcement. Federal health care officials had already implemented a similar measure for the nation’s skilled nursing facilities (SNFs).

“For the first time, anyone can now review detailed information on the ownership of more than 6,000 hospices and 11,000 home health agencies certified to participate in the Medicare program on the U.S. Centers for Medicare & Medicaid Services (CMS) website,” the agency said in the announcement.

The Biden administration has been focused on health care transparency since President Biden’s early days in office.

To a degree, the ownership-transparency efforts are tied to the public health emergency (PHE) and multiple negative reports about the performance of for-profit and private equity-backed nursing home operators amid the pandemic.

“It’s plain and simple: families deserve transparency when making decisions about hospice and home health care for their loved ones,” HHS Secretary Xavier Becerra said in a statement. “President Biden has called for unprecedented action to increase transparency – and we are making more data publicly available than ever before. Shining a light on ownership data is good for families, good for researchers, and good for enforcement agencies.”

CMS initially released data publicly on mergers, acquisitions, consolidations and changes of ownership for hospitals and nursing homes enrolled in Medicare in April of last year.

In September, CMS then released additional data publicly on the ownership of roughly 15,000 nursing homes certified as a Medicare SNFs.

Most recently, in December, CMS released detailed information on the ownership of more than 7,000 hospitals certified to participate in the Medicare program.

“Transitioning to hospice care is often an emotionally overwhelming time for many families,” CMS Administrator Chiquita Brooks-LaSure said in a statement. “Making this data public increases transparency, giving families the information needed to help them identify the best care for their loved one.”

This action was among 34 recommendations for improving program integrity sent to CMS in January by four industry groups, the National Hospice and Palliative Care Organization, the National Association for Home Care & Hospice, LeadingAge and the National Partnership for Healthcare and Hospice Innovation.

Pushing transparency

Among the information on hospice ownership that CMS is making available is enrollment information, organization name, type, practice location addresses, National Provider Identifier (NPI) and CMS Certification Number (CCN).

The agency is also sharing detailed information about each owner and subsidiaries.

Additional material being posted online includes data on mergers, acquisitions, consolidations and changes of ownership since 2016 – for both hospices and home health agencies alike.

“HHS plans to analyze these data to identify ways to inform policy approaches that can improve competition in health care, a key priority for the Biden-Harris administration,” Thursday’s announcement noted.

When CMS released ownership data on nursing homes, reactions were mixed. Most stakeholders agreed that health care transparency is a good thing, but some feared ownership data without context would cause confusion.

Rick Matros, CEO of California-based Sabra Health Care REIT (NASDAQ: SBRA), effectively said as much earlier this year. Sabra invests in skilled nursing, senior housing and behavioral health facilities across the nation.

“It doesn’t impact us in a tangible way because it doesn’t impact us financially or anything like that,” Matros said, referring to any potential business implications of ownership data being posted. “But for the public, … I think it creates a negative image. So that impacts us; it’s just not tangible.”

Hospice leaders have already echoed similar remarks in response to Tuesday’s news. Dr. Tara Friedman, CMO of Chapters Health System, is among them.

Speaking at the Hospice News Palliative Care Conference, Friedman explained how fraud, waste and abuse can happen across the health care system regardless of provider-ownership type.

“I am confident in saying this repeatedly and in any audience that will listen: The issue is not the tax status of the institutions,” she said. “I just want to caution all of us about what information we’re putting out there, because we could get rid of all the for-profits in the hospice industry, but health care is still going to be a for-profit business.”

Chapters Health System is a community-based, not-for-profit organization that delivers hospice, palliative and home health care services across most of Florida and parts of Georgia.

Helping the public understand that bad actors can be found among different ownership types is important, Friedman said. But overall, transparency is something to drive for, she continued.

“I think transparency is great,” she said. “I think publish everything.”