The Elevate Hospice Conference, hosted by Hospice News, was held on September 7th, in Chicago. Industry stakeholders shared emerging trends across the hospice industry to power leaders forward. Here is what we learned at the conference this year:
Workforce Challenges Remain Top of Mind
With nursing shortages on the rise and more nurses being at-risk of leaving the field altogether, hospices must work hard to create friendly work environments. Recent analysis suggests that younger, less experienced nurses suffering from pandemic-related burnout are more likely to quit in upcoming years. According to the research, 900,000 out of the nation’s 4.5 million registered nurses are expected to leave the workforce by 2027. Most of these nurses put up with intense workloads during the pandemic, and increasing burnout has doubled the risk of more of them wanting to leave the industry.
Hospices stand to benefit from the integration of technology into their daily workflows, and even reduce burnout among nurses and other care providers. For instance, HIPAA compliant communication technology such as Hucu.ai alleviates caregiver burdens, improves their work-life balance and reduces stress among them. The 24/7 nature of hospice care makes it a challenging role, as patients and families might need assistance at any point in a given day. Hucu.ai centralizes all patient-related communication, thereby providing care team members and patient families with real-time information in one virtual setting. This makes it easier for hospice providers to manage their daily workloads, save time, feel less overwhelmed and instead channel all that positive energy towards better patient outcomes.
Hospice Offers Potential Savings to Medicare
The idea of specialized care for the dying first surfaced in a lecture at Yale university by renowned social worker, physician, and writer, Dame Cicely Saunders. It took two decades for that to translate into a Medicare benefit under the Tax Equity and Fiscal Responsibility Act of 1982. The ratio of Medicare beneficiaries enrolled in hospice care has gradually risen from 2015, and so has Medicare spending on hospice totalling $20.9 billion in 2019.
Recently, a NORC study found the total costs for Medicare-enrolled hospice users in their last year are lower compared to those beneficiaries who had not used hospice. They also found that earlier enrollment in hospice, with longer length of stays, holds potential for additional value for Medicare. NORC findings strongly support that hospice enrollment benefits patients, families, caregivers, and reduces overall Medicare spending and costs. Patients with earlier hospice enrollment had higher satisfaction, improved quality of life, and relatively less physical and emotional distress. In sum, we can see how hospice adds value in lowering Medicare spending for those who used it in their last year, but that it adds greater value to the lives of patients, their families plus the caregivers.
Testing Value Based Care Opportunities
Hospices are moving towards value-based reimbursement, and are gradually moving past its infancy stage towards a long journey that lies ahead. CMMI (Centre for Medicare and Medicaid Innovation) is currently covering hospice care through Medicare Advantage with the Value-Based Insurance Design (VBID) program. Whether the VBID model becomes fully integrated is yet to be seen, but hospices will definitely see value-based payment systems grow more dominant with time.
According to Liz Fowler (CMMI Director),
“Promoting value based care is a passion and a mission, and I believe it is the right direction for our health system and the right approach to improve the health care experience for patients.”
The VBID program also consists of a palliative care component, and participating providers are required to provide palliative care in order to stay part of the program. As of next year, hospices can also take part in the ACO Reach Program, which provides them with yet another opportunity for transitioning into value-based care models.Value-based programs have received substantial backing and will continue to be more and more important for hospice providers.
Hospice Plays Key Role in Transforming Healthcare
Hospice is playing a key role in transforming healthcare from vertical to horizontal delivery across the entire continuum of care. One recent study found that hospice savings for Medicare totalled at almost $3.5 billion for patients in their last year of life. In the words of Devin Woodley (VP of Managed Care and Contracting at VNS Health),,
“We are encouraged by our participation in the VBID demonstration project. We are able to provide the right kind of care at the right time with palliative care leading seamlessly to hospice. It has been a huge benefit for patients, providers and the payer. In fact we measured 32% lower hospital admits, 41% shorter length of stay and 53% lower readmissions.”
Earlier hospice enrollment further lowers Medicare spending. Therefore, it is pertinent that we educate patients about what end-of-life care options are available to them. This would make more patients opt for hospice sooner than they would in their disease trajectories. This in turn, would generate greater savings for Medicare and limit costly medical interventions. Likewise, expanded palliative care gives a great boost to enrollment in hospice. More and more hospices in recent years have begun to invest in palliative care programs. Data confirms a greater likelihood among critically ill patients choosing hospice at the end of life, if they had received palliative care services prior to that. Palliative care will also assist healthcare organizations with many goals such as, lowered costs, improved patient satisfaction and better quality of life.
Analytics are Critical to Driving Successful Outcomes
Healthcare is changing faster than ever, and so, data analytics can support hospice and palliative care providers in a rapidly changing field. Data analytics help hospice and palliative organizations gain greater insight into patient needs, avoid potential risks and increase the overall quality of care. Data analytics are a valuable asset when it comes to care planning. Data can be used for analyzing patient diagnosis, symptoms, and determining which care plan is the most effective moving forward. This will allow care providers to alter individualized patient care plans more suited to achieving the desired outcomes.
Data analytics also increase quality of care, and this will prove fruitful as most hospice and palliative care providers struggle with showing the quality of care they provide to their patients. They can also help in assessing areas for quality improvement, such as lowering hospital readmissions, improving pain management, and alleviating caregiver stress. Data analytics will help hospice and palliative care providers in identifying emerging trends, assess changes in patient demands, and in helping them in developing long-term strategic plans. For instance, data analysis on patient information, symptom management, and end-of-life care preferences will unleash patterns that drive improved delivery of care.