Hospice is a realm of medicine concerned not with curing patients, but helping them end their lives with comfort, meaning and dignity. But, with a major transaction under consideration, Oregon lawmakers got a reminder last month that the hospice business model has imperatives of its own.

Through Medicare, the federal government pays hospice providers a per diem for each beneficiary, regardless of service provided that day. And given that most services must be rendered at the beginning and end of a patient’s stay, a grim financial logic emerges: “Patients that typically die within 7 to 14 days of being in hospice are not as profitable as those that have longer lengths of stay,” Robert Tyler Braun, a Cornell University researcher, said as part of the presentation to a state Senate health ca

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