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Artificial intelligence is causing quite the buzz in the hospice and palliative care spaces thanks to its ability to turn real patient data into actionable items for providers. These tools can help prognosticate more accurately, enable objective examination of a patient’s status, and much more.
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How Primary Care First and the SIP model re-center family physicians in advanced illness care
As 2021 approaches, hospices and other organizations participating in Primary Care First are gearing up to tackle their new patient loads. The Centers for Medicare and Medicaid Services’ (CMS) Primary Care First (PCF) program, which will start enrolling patients in 2021, includes the Seriously Ill Population (SIP) model. The SIP program is designed to improve care for high-need, high-risk patients who are receiving fragmented or inadequate care.
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Quality care is vital to any medical organization’s success and, of course, the health and outcomes of their patients. But most physicians don’t receive any formal training on quality during their schooling or residency, which means most learning on the topic happens on the job.
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Bridging the gap between payer/provider groups, and hospices/SIP providers
Prior to COVID-19, payers were already experiencing a number of stressors: meeting quality metrics, maximizing patient and provider satisfaction, minimizing acute care utilization, and more. Now, amidst a global pandemic, that list has only gotten longer.
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In research by Dr. Arif Kamal, Chief Medical Officer of Acclivity Health, palliative care physician shortages are predicted to send patient-to-provider ratios skyrocketing in the coming decade —1:808, to be exact. The reasoning? Dr. Kamal and his team found that one-third of palliative care clinicians are burned out, and two in five are 56 years of age or older. There are about 7,600 physicians board-certified in palliative care. That number is not increasing, meaning as burnout mounts and physicians age, there are no new providers waiting to take their place.
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Hospice providers have increasingly adopted predictive analytic systems to identify patients in need of their services further upstream in their disease trajectory, as well as to demonstrate their value to payers and referral partners, including Medicare Advantage plans. The U.S. Centers for Medicare & Medicaid Services (CMS) will begin allowing hospices to participate in Medicare Advantage in 2021 with the value-based insurance design demonstration project.
The pandemic forced providers into online care. Will they stay logged in once they can see patients in person?
The coronavirus pandemic has changed nearly every facet of how hospice care is delivered during this time. But when it comes to hospices adopting telehealth in response to the virus, many are wondering if care delivery online will carry into the future. Historically it has been difficult for hospices to establish strong telehealth programs, but now that COVID-19 has forced the issue, what does the path forward look like?
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Change is coming for hospices in 2021 as the industry starts to shift towards value-based payment models, including the Primary Care First initiative. As the implementation dates for these programs approach, hospices need to identify the value proposition and revenue potential for each of the models that will fall under the auspices of that program.
Our very own Robin Stawasz, LMSW and program development executive recently was interviewed by Stan Massey of Transcend Strategy Group. During the conversation, they discussed the emerging uses of telehealth and remote care tools used to improve care and the overall patient-family experience by offering more comprehensive monitoring and instant communication.
The leadership team at Acclivity Health recently wrote a peer reviewed article that was published in April issue of The American Journal of Managed Care. Here’s an excerpt of the abstract:
Palliative and hospice care services produce immense benefits for patients living with serious illness and for their families. Due to the national shift toward value-based payment models, health systems and payers share a heightened awareness of the need to incorporate palliative and hospice services into their service mix for seriously ill patient populations.
During the last decade, a tremendous amount of capital has been invested to better integrate information technology into healthcare. This includes development of technologies to promote utilization of palliative and hospice services. However, no coordinated strategy exists to link such efforts together to create a cohesive strategy that transitions from identification of patients through receipt of services.