Hospice Improving as Medicare Advantage Approaches

The improvement of quality can enhance the patient care system and hospice’s bottom line when hospices prepare to demonstrate their value proposition to the payers once the Medicare Advantage hospice carve-in issues in 2021. It will enable the providers to benefit from transforming their organizational cultures and channeling their workforce towards a pay-for-performance outlook in anticipation of the changes in the payment model.

Senior director of regulatory and quality for the National Hospice and Palliative Care Organization (NHPCO), Jennifer Kennedy said,

“When we look at quality care provision, providing high-quality care and experience in a patient center model is a necessity and not just nice to have for today’s hospice provider. When you look at health care and quality in the United States, we have the highest rates of avoidable mortality because people are not receiving timely, high-quality care. The government is invested in making sure that the cost of care is within containment, but also that the quality of care isn’t lost when dollars are contained being spent on health care. The aim is to improve overall care by making care more patient-centered.”

This motive has fueled hospice leaders and has encouraged them to create change from the inside out. Even though legislation is seeking to delay the implementation of the value-based insurance design (VBID) model demonstration project and forcing it to start in 2023, it is still not stopping hospice providers. Hospice providers are all set for impact and planning strategies for best sustainable practices

In addition to her earlier statements, Jennifer Kennedy said,

“We’re seeing payment models that are being developed at the [U.S. Centers for Medicare & Medicaid Services (CMS)] level that are focusing on innovation and value-based purchasing. That is here to stay, and we’ll see moving forward. Workforce development is an investment in people to prepare the next generation of health care professionals and support that lifelong learning for providers that they will need to provide high-quality care. Organizations have the opportunity to deliver quality care to their patients and their families by committing to developing a culture of continuous quality improvement and patient-centered care. Having a person-centered model is not enough. It needs to be adopted into that organizational culture.”

President and CEO of The Elizabeth Hospice in California, Sarah McSpadden, in a recent interview said,

“Currently, we are doing a pay-for-performance model for our staff and it’s creating a cultural shift. Takeaways from the shift in performance are to keep the standards objective to ensure that they’re accountable and measurable. Include all the stakeholders in the determination of the reward. Talk about quality with everyone in the organization and celebrate it often. Celebrate the tick up in something you’re measuring. Celebrate all the changes you’re creating in better patient care outcomes for the people in your community, and then make success possible on an individual basis for accountable staff that uniformly follows standards and holding each other to them.”

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