NHPCO NewsLine Fall 2021 - 11

directly and submit claims for non-hospice care,
such as advance care planning and palliative care
services. This can also include behavioral health
services. Find more information on Part B is
available on the Medicare website.
▌ Inclusive care systems: Some healthcare systems
have taken on both payment and provider
responsibilities - known as " payviders " - and are
providing " womb to tomb " care. They are offering
all-inclusive care that focuses on patient-driven,
home centered care for the patient's entire life.
Some very impressive new care models are
emerging, such as utilizing ambulance services to
provide in-home triage and support services,
leveraging new technology to monitor patients in the
home for their safety, educating patients and
caregivers in effective disease self-management,
and utilizing peer education and support. You can
use your knowledge of the populations you serve,
your connection with community resources, your
experience in what truly makes a difference, and
your creativity to develop the care models that will
move your mission forward.
Even with a better understanding of the care models
available, as well as some insight into how to make
such models sustainable, you may still face obstacles
to diversification. One such barrier may be your size.
If you are a smaller provider, especially in a crowded
market, you may lack resources and find it difficult
to get noticed by some of the larger payer or
provider systems.
One option is to combine forces with other hospices
and like-minded providers. You can build informal
and formal networks between partner organization
to share expertise, combine advocacy and outreach
efforts, and mutually problem solve. Then, these
collaboratives can look to empower collective
bargaining and contracting efforts, allowing you to
go to potential contractors as a group. This provides
the contractor an ease of effort and economy of
scale to a much greater extent than having each
individual organization approaching them
separately. With such contracts in place, your
organizations can explore sharing certain backoffice
efforts, such as billing or QA, as well as some
clinical work, such as telephonic on-call and care
management. This can even be taken to the next
step of merging or creating a new collaborative
organization. Acquisitions are also possible to
increase your scope and market.
Making Change Happen
Once your organization has committed to change as
part of your overall strategy and you have explored
your clinical and payment model options, the next
step is making the change a reality. While this is
structured and methodical process, it also calls for
creativity, flexibility, continual communication, and
persistence.
Build your data: Historically, hospices have not
taken full advantage of the data available to us. We
know that we have a positive impact on outcomes
- cost, patient satisfaction, acute utilization,
provider satisfaction - but have not been able to
quantify that impact. The first step is using the
data you have. Use your own financial and clinical
records to understand your costs, including your per
visit costs, your average costs per unit of service,
your staffing costs per clinical discipline, and
whatever additional segmentation is meaningful to
you and your situation.
The first step is using the
data you have.
Newsline / Fall 2021
11
https://www.medicare.gov/what-medicare-covers/what-part-b-covers
NHPCO NewsLine Fall 2021

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