It has been more than a third of a century since I entered the hospice field as a clinician. During that time, I have seen many changes and new market pressures. But nothing compares to the changes in the market that have occurred in the past few years. The growth of value-based payment models, the very real financial crisis that Medicare currently faces, the ability to run hospices at a high-profit margin, the increase in hospice utilization, and the increasing valuation of home-based care have all combined to put home-based post-acute care providers in a completely different market position. Some of these changes are positive, creating opportunities and leverage not seen to this point. Some of the changes are very challenging, threatening to drastically alter how serious illness care is provided and who is providing it.
Change is being seen in two directions. On the one hand, new entities are coming into the post-acute care space, creating new market pressures and care models to challenge traditional providers. Large health systems, hospitals, provider groups, payers, private equity firms, multi-state agencies, and home health companies are all exploring providing hospice and hospice-adjacent services. On the other hand, post-acute care providers, such as hospices, are expanding their service lines and partnering or merging with other providers, bringing them into areas of the care continuum that had been previously inaccessible. Hospice and palliative care providers are now providing care management services, primary care, SDOH management, remote patient care, and much more, as well as taking on direct financial risk and responsibility for patient care. Mergers, purchases, private equity investment, and consolidations have permanently changed the healthcare landscape, altering the field for all.
This change is not inherently good or bad. There are gains and losses across the board. The one thing, however, that cannot be denied is that all providers are going to be impacted. How your organization will fare will be determined in part by the strategies you put into place. Whether your organization chooses to ride this wave or wait for it to pass must be a purposeful decision made with full awareness of the consequences of that decision. You must then put an action plan into place to ensure that this is followed up on and that the priorities of your mission are properly shepherded. The first step is educating yourself on what is happening in the field of post-acute care and where you fit within that.
“Hospice Investment Trends that could Shape 2024” by Holly Vossel, posted by Hospice News on October 19, 2023, and accessible at https://hospicenews.com/2023/10/19/hospice-investment-trends-that-could-shape-2024