The Impact of For-Profit Hospice Providers on End-of-Life Care for Prostate Cancer Decedents
Abstract: Since its inception in 1983, the Medicare hospice benefit has provided palliative and supportive care for patients and families near the end of life. The rapid growth of for-profit providers has raised concerns about how financial incentives influence care delivery and quality. Using SEER-Medicare data from 2008–2017, we examine the relationship between for-profit hospice enrollment and care outcomes among 63,926 prostate cancer decedents. To address selection bias, we apply a two-stage least squares instrumental variables approach, leveraging local for-profit hospice share as an instrument. Our estimates indicate that patients in for-profit hospices experience longer lengths of stay, but also higher rates of live discharge and burdensome care transitions in the final week of life. These results suggest that financial incentives may shape hospice practices in ways that complicate care coordination. Link to Paper; Appendix
Published Works
1. Lindsay M. Sabik, Jacob Whitman, Donald Bourne, Zhaojun Sun, Eric T. Roberts, Jonathan G. Yabes, Manisha Bhattacharya, David Bartlett, Bruce Jacobs. “Impacts of a Rural Hospital Global Budget Alternative Payment Model on Patterns of Cancer Surgery.” Medical Care, forthcoming.
2. Avanish Madhavaram, Jacob Whitman, Cailey Sanborn, Cameron Jones, Aniket Asees, Kathryn Marchetti, Benjamin Davies, Janel Hamner, Bruce Jacobs. 2026. “Patient Preferences for Treatment of Intermediate Risk of Prostate Cancer: A Discrete Choice Experiment.” Urology.
3. Jacob Whitman1, Andria Eisman1, Lawrence Palinkas, Judy Fridline, Christina Harvey, Amy M. Kilbourne, David Hutton. 2026. “Economic Evaluation of Implementation Strategies for School-Based Universal Prevention: Insights from a Pilot Study.” Mental Health & Practice.
4. Jacob Whitman, Dylan Nagy, Harsheni Sudakar^, Coleman Drake, Yael Schenker, Lindsay Sabik. 2026. “Geographic and Sociodemographic Disparities in Access to Hospice in Pennsylvania.” American Journal of Hospice and Palliative Care.
5. Andria Eisman, Jacob Whitman, Suzanne Brown, Erica Richardson, Christina Holmes, Barry Schmidt, Eric Swihart, Tracy Robinson, Bo Kim. 2025. “Investing in Infrastructure: A Mixed-Methods Cost Analysis of Implementation Strategies to Address Emerging Youth Drug Trends.” Journal of Studies on Alcohol and Drug-Use.
6. Jacob Whitman. 2025. “Locking Up Restaurants: Did COVID-19 Lockdowns Shift U.S. Consumption Patterns?” International Journal of Food & Agriculture Economics.
7. Andria B. Eisman, Jacob Whitman, Christine Koffkey, Lawrence Palinkas, Judy Fridline, Christina Harvey, Amy Kilbourne, David Hutton. 2023. “A Mixed Methods Shareholder-Focused Cost Analysis to Deploy Implementation Strategies for School-Based Prevention.” Implementation Science Communication.
Papers Currently Under Review
1. Jacob Whitman, Eric T. Roberts, Jonathan G. Yabes Donald Bourne, Zhaojun Sun, Manisha Bhattacharya, Jeremy Kahn, Bruce Jacobs, Lindsay M. Sabik. “Cancer Surgery Outcomes following Global Budgets in Rural Hospitals” (Revise & Resubmit, Annals of Surgery)
2. Jacob Whitman, Harsheni Sudakar^, Lindsay Sabik, Yael Schenker. “Geographic Disparities in High Quality Hospice Care.” (Revise & resubmit, Journal of Palliative Medicine)
3. Jacob Whitman, Ana Milan Hinostroza. “Drunk Driving During the Pandemic: Understanding the Effects of Alcohol To-Go Laws.” (Revise & Resubmit, Journal of Studies on Alcohol and Drug-Use)
4. Andria B. Eisman, Jacob Whitman, Christine Koffkey, Lawrence Palinkas, Judy Fridline, Christina Harvey, Amy Kilbourne. “Bridging the Gap: A Pilot Study of Implementation Strategies for School-Based Universal Prevention on Student Mental Health and Substance Use Outcomes” (Under review)
5. Jacob Whitman, Xiaoxue Li, Shooshan Danagoulian. “Short-Run Shifts, Limited Persistence: Diet Quality in Grocery Purchases under COVID-19 Stay-at-Home Orders” (Under review)
Working Papers
1. Jacob Whitman, Stuart Case, Zade Abou-Rass, Andria Eisman. “Substance Use Risk and Mental Health Symptoms Among High School Students: The Moderating Role of School District Context”
2. Jacob Whitman, Bruce Jacobs, Jonathan G. Yabes, Yael Schenker, Lindsay M. Sabik. “The Impact of For-Profit Hospice Providers on End-of-Life Care for Prostate Cancer Decedents” Link
3. Jacob Whitman, Jill Horowitz, Travis Donahoe, Zhaojun Sun, Jonathan Yabes, Victoria Wyant, Jacqueline Patel, Yael Schenker, Lindsay Sabik. “Spillover Effects of Opioid-Control Policies on End-of-Life Opioid Access for Patients with Advanced Cancer”