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.
Heart failure impacts 6.2 million American adults. With no cure, therapies aim to prevent progression and manage symptoms. Inclusion of palliative care (PC) helps improve symptoms and quality of life. Heart failure guidelines recommend the inclusion of PC in HF therapy, but referrals are often delayed.
During these historic times, many healthcare providers are struggling to provide care in the same ways they did before COVID-19 disrupted everyday lives. To alleviate these pressures and to facilitate continued support to fight COVID-19, the President instituted protocols to give governmental agencies, like the Centers for Medicare and Medicaid Services, the authority to invoke proactive methods to ease the strains being faced by providers without compromising care delivery. The emergency declarations were made on March 13, 2020, and a new set of blanket 1135 waivers inclusive of hospice was released March 30, 2020.
Read moreFor Jill Hofstede, whose 90-year-old mother has Alzheimer’s disease, news about the coronavirus becomes more terrifying every day.
Although the potential shortages of mechanical ventilators and intensive care beds have made headlines, Hofstede fears a surge of COVID-19 patients could deprive her mother of something far more basic should she contract the disease: relief from pain and suffering.