Hospice Disenrollment Trends Shifted for Dementia Patients
A new study reveals how often dementia patients leave hospice care and why for-profit facilities report higher rates.
Updated on Sept. 21, 2026 in Alzheimer’s
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Researchers analyzed Medicare data for over 1.4 million dementia patients between 2012 and 2019, finding that overall hospice disenrollment rates saw a slight decline from 24.0% to 23.2%. This retrospective study highlights critical gaps in care continuity as patients move between providers or change service areas.
Why it matters
Understanding these disenrollment patterns is vital for families coordinating end-of-life care, as frequent transitions can disrupt support and potentially trigger emergency hospitalizations. The data underscores the importance of evaluating whether a facility's structure aligns with a patient's long-term needs.
A serial cross-sectional study of over 1.4 million Medicare beneficiaries, with a mean age of 86, analyzed hospice disenrollment between 2012 and 2019. Findings showed a 30.5% disenrollment rate for for-profit hospices compared to 18.3% for nonprofit facilities by the end of the study.
The players
Journal of the American Geriatrics Society
A peer-reviewed medical publication focusing on clinical research and health policy concerning the aging population.
The details
Researchers measured disenrollment as the percentage of patients discharged alive from hospice services. The study observed that while discharges for extended prognosis fell, transfers between agencies and moves out of service areas rose, with nearly half of the latter group requiring hospitalization within 3 days. These trends occurred against the backdrop of federal regulatory changes, including the Improving Medicare Post-Acute Care Transformation Act and Hospice Payment Reform.
Timeline
September 2012 marked the beginning of the study period for hospice discharges.
The Improving Medicare Post-Acute Care Transformation Act was implemented in 2014.
Hospice Payment Reform measures were implemented in 2016.
The study period for hospice discharges concluded in December 2019.
The research was published in the Journal of the American Geriatrics Society on September 15, 2026.
Health Landscape
This analysis tracks how hospice care for dementia patients evolved following the implementation of the Improving Medicare Post-Acute Care Transformation Act. It situates current care patterns within a decade of federal regulatory changes aimed at standardizing quality across hospice providers.
If you or a loved one are enrolled in hospice, ask your care team about their policy regarding transitions and how they coordinate with local hospitals. Because moving service areas is associated with higher hospitalization risk, these details are worth discussing with your doctor.
The takeaway
Disenrollment rates vary significantly by hospice ownership type, with nonprofit facilities showing lower turnover than for-profit ones. Families should prioritize evaluating a provider's stability and historical transfer rates when selecting a hospice partner for dementia care.
Further reading
For additional context on managing long-term conditions, visit our Alzheimer’s section.
Source note: This article includes information reported by Medscape.
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