Thursday, July 14, 2016

Feature Your Program Successes at MLC 2017

NHPCO returns to the Washington Hilton for the 2017 Management and Leadership Conference from May 1 – 3. NHPCO is seeking proposals from hospice and palliative care experts designed to advance the knowledge, competence and performance of hospice and palliative care managers and leaders.

NHPCO’s 2017 Management and Leadership Conference learning objectives:

  • Strengthen executive leadership and management skills; 
  • Discuss innovative strategies to respond to changes in the regulatory, health policy and healthcare landscapes;  
  • Develop strategies to adapt to current reimbursement for hospice care and discuss options being considered for the future;  
  • Examine reimbursement options/models for palliative care service provision;
  •  Create organizational systems and processes to adapt to changing circumstances;
  •  Provide tools to ensure the provision of quality, evidence-based, ethical, effective and efficient end-of-life care;
  •  Analyze innovative approaches to improve access to hospice and palliative care by underserved and marginalized populations; 
  •  Highlight exceptional quality assessment and performance improvement practices.
Over 60% of MLC participants have 11+ years of professional experience in the hospice and palliative care field. Thus, proposals to be considered for this conference must be geared toward the expert (advanced) or proficient (intermediate) levels for seasoned hospice palliative care executives and leaders; preference will be given to these proposals. 

Advance leadership in the hospice and palliative care field by submitting a presentation proposal by Wednesday, August 17, 2016; MLC 2017 Proposals.

NHPCO returns to Washington, DC for the 2017 MLC.

Thursday, July 7, 2016

Community-Based Palliative Care

http://www.nhpco.org/resources/nhpco-edge

By K. Jeanne Dennis, MSW
Associate Consultant, NHPCO Edge
 

When the winds of change in health care blew our way many of us in hospice cheered, our time had come! Hospice was the one provider that was hitting the triple aim: better quality of health for a population of patients, better health care and at a lower cost. But are the health care providers and payers in our communities flooding our phone lines and email boxes to partner with us, learn from us, contract with us? In some cases perhaps, but mostly we are hidden in plain site, fighting for a seat at the table (with ACOs, DSRIPs, Medicare Advantage plans, PCMHs, etc.) What happened? Why is the hospice model of care not promoted as the solution to the problem of improving quality of care and saving health care dollars? Consider two reasons: Internal barriers and external competition. 

Internal Barriers: 
  • Unprecedented Changes in the core hospice business that require significant operational focus and resource allocation.
  •  Funding: with no distinct palliative care benefit, and the options of Medicare B and/or fund raising lacking the promise of a breakeven bottom line, the financial case is too hard to make.
  •  Infrastructure: Although a community-based palliative care service is anchored in the hospice model, it requires an investment in recruitment and education of staff, an EMR, policies and procedures, a marketing plan, and more.
  •  Strategic Positioning: with some notable exceptions, hospice programs did not have the planning and palliative care program structure ready to go.
  •  Value Proposition: participation in the new shared saving and risk sharing opportunities demands data that demonstrates value. Pulling this information is a challenge for many hospice providers.
External Competition: The lack of distinct Medicare Conditions of Participation or a benefit structure opened up the opportunity for palliative care innovation by other providers and by payers. For example:
  • Large health care systems are already creating post-acute services designed to manage patients in the community and reduce re-admissions
  • Physician groups (often part of a large system) are now expanding home visit and tele-medicine services
  • Major health insurance companies are implementing care management programs with the ability to scale beyond the usual boundaries of most hospice programs
  • New entrants in the field like Aspire Health, a for profit company founded in 2013, now providing community based palliative care in 11 states and the District of Columbia. Aspire has the advantage of a well-known Board Chair, Bill Frist, MD, former Senate Majority Leader and $21m in venture capitalist funding.

The good news is that it’s not too late to succeed. Community-based palliative care is in our DNA, and the opportunity to shape the future of care for a vulnerable population is now. The innovation in palliative care that’s happening among hospice providers is encouraging and exciting. For hospice leaders this service is emerging as a top strategic priority. Hospices are now taking action aimed at clearing the barriers. Record-breaking attendance at NHPCO’s Palliative Care offerings at the recent MLC is evidence of the energy and interest in adapting the hospice principles, practices and proficiencies to meet the care needs in the community and the mandates of the new value based payment models.
NHPCO is committed to leading these efforts and NHPCO Edge is here to provide support and consultation.

This post was written by K. Jeanne Dennis, NHPCO Edge Associate Consultant. NHPCO Edge is proud to count Jeanne among our expert consultants, as she brings decades of experience in hospice leadership. For more info, see NHPCO Edge online.

See our previous NHPCO Edge blog, "Using Metrics for Marketing." 

Wednesday, June 29, 2016

New Video Communicates the Benefits of Hospice Care to Diverse Audience

Grandma Luk and her hospice nurse.
The National Hospice and Palliative Care Organization is thrilled to release a video translated in Mandarin highlighting how hospice care can help patients and families navigate end-of-life challenges.  “The Journey of Grandma Luk” is part of the “Moments of Life: Made Possible by Hospice” campaign, a national public awareness campaign created by NHPCO to help the public understand how hospice and palliative care supports patients and families live as fully as possible, despite a terminal illness.

The story features an 88 year old Brooklyn resident originally from China matriarchnamed Sheung Lung Luk. Grandma Luk, as she came to be known, received hospicecare after being diagnosed with terminal lung cancer. It was under the care of MJHS Hospice and Palliative Care that Grandma Luk’s pain was stabilized and she was able to enjoy doing the things she loved most.  As seen in this story, the family was particularly relieved to have the support of a hospice nurse who could communicate with them in Chinese. 

This video is the first in the campaign to be translated in Chinese, and is now showcased on the “Moments of Life” website. The decision to add Chinese resources is part of a larger diversity initiative at NHPCO.  As shown in NHPCO’s Facts and Figures, “Patients of Minority (non-Caucasian) race accounted for about one quarter of hospice patients in 2014.”

To support the work of hospice providers, a newly-revised version of NHPCO’s Chinese Outreach Guide is now available online, free of charge. The guide outlines key principles and insights to help hospices better serve this diverse community. Additional resources made available for Mandarin Chinese speaking families include the brochures: 

New Video Communicates the Benefits of Hospice Care to Diverse Audience

Grandma Luk and her hospice nurse.
The National Hospice and Palliative Care Organization is thrilled to release a video translated in Mandarin highlighting how hospice care can help patients and families navigate end-of-life challenges.  “The Journey of Grandma Luk” is part of the “Moments of Life: Made Possible by Hospice” campaign, a national public awareness campaign created by NHPCO to help the public understand how hospice and palliative care supports patients and families live as fully as possible, despite a terminal illness.

The story features an 88 year old Brooklyn resident originally from China matriarchnamed Sheung Lung Luk. Grandma Luk, as she came to be known, received hospicecare after being diagnosed with terminal lung cancer. It was under the care of MJHS Hospice and Palliative Care that Grandma Luk’s pain was stabilized and she was able to enjoy doing the things she loved most.  As seen in this story, the family was particularly relieved to have the support of a hospice nurse who could communicate with them in Chinese. 

This video is the first in the campaign to be translated in Chinese, and is now showcased on the “Moments of Life” website. The decision to add Chinese resources is part of a larger diversity initiative at NHPCO.  As shown in NHPCO’s Facts and Figures, “Patients of Minority (non-Caucasian) race accounted for about one quarter of hospice patients in 2014.”

To support the work of hospice providers, a newly-revised version of NHPCO’s Chinese Outreach Guide is now available online, free of charge. The guide outlines key principles and insights to help hospices better serve this diverse community. Additional resources made available for Mandarin Chinese speaking families include the brochures: 

Wednesday, June 22, 2016

Personalize Your Care Act Provides Tools Needed to Make Important Care Planning Decisions


As America’s aging population grows, individuals with chronic and advanced illnesses will need access to resources and tools to help make informed choices about advance care planning.  The Personalize Your Care Act of 2016, introduced today by Congressman Earl Blumenauer (D-OR) and Congressman Phil Roe (R-TN), increases accessibility to and public awareness of advance care planning.  It also authorizes a demonstration project to allow individuals with advanced illness to access hospice and palliative care services without forgoing conventional therapies. 

“The National Hospice and Palliative Care Organization enthusiastically supports the Personalize Your Care Act of 2016 and applauds the leadership of Representatives Blumenauer and Roe,” said President and Chief Executive Officer of NHPCO, J. Donald Schumacher. “Self-determination is at the core of the hospice philosophy and care model, and we believe that the Personalize Your Care Act will allow some of our most vulnerable patients to have information and support they need to make healthcare decisions. 

The introduction of the legislation coincides with a Congressional screening of the PBS Frontline documentary “Being Mortal” NHPCO is hosting Wednesday, June 22.  Best-selling author and physician Dr. Atul Gawande will be joined by singer, songwriter, and family caregiver Rory Feek in a panel discussion on how we, as a nation, can provide better care for people with serious, potentially life-limiting illness. 

“Conversations about end-of-life care can be difficult, but it’s extremely important for patients and their families to make these decisions with their medical providers,” says Congressman Roe. “I’ve been on both sides of these discussions – as a physician and a family member – and I know firsthand the peace of mind that comes with knowing a patient or loved one’s wishes. This bill will ensure patients, families and medical professionals have the resources and tools they need to navigate these sensitive but necessary conversations, and I am proud to partner with Congressman Blumenauer on this legislation.” 

The Personalize Your Care Act will increase public awareness through additional Medicare coverage for Advanced Illness Management and Choices Demonstration which allows more accessibility and more choices in care services.  The legislation also requires that advance directives be included within a patient’s electronic health record in order to increase the likelihood that the documents are kept up-to-date and easy to locate.  

"Medicare providers are now being reimbursed for having thoughtful and thorough conversations with patients and their families about end-of-life choices. Our legislation builds on what we’ve accomplished to further ensure patients’ wishes for care are understood, respected, and enforced.” said Congressman Blumenauer. 

As an organization committed to increasing awareness of advance care planning, NHPCO provides free information and tools to the public.  NHPCO’s Caring Info has state-specific advance directive forms and information on advance care planning that can be downloaded from its website caringinfo.org/stateaddownload.   Each state’s advance directive is legally reviewed on an annual basis and meets each state’s statutory requirements.

Monday, June 13, 2016

NHPCO Statement on the Tragedy in Orlando

In the early morning hours of Sunday, June 12, a senseless act of violence in a nightclub in Orlando has left us horrified, angry, frightened and confused. Hate and terror were targeted at our nation’s LGBT community and the wounds touch us all. Very rarely can such violence be explained in any manner that makes sense to rational people.

Our thoughts and prayers go out to all those affected by the shooting in one of America’s cities visited by tourists from around the world. We offer a prayer for the families whose lives are forever changed. We stand in support of the LGBT community and all those who feel marginalized by the evils of racism and discrimination.

Upon reflection of Sunday’s tragic event, we are reminded of the courage and skill of our nation’s first responders and law enforcement. We are touched by the acts of kindness by many who came to the aid of the seriously injured and frightened. We are moved by the lines of fellow citizens gathering to donate blood or joining together to lift their voices in support of love, equality and democracy. We are also reminded of the resilience of the American people. The Twenty-first Century seems to reflect an increasingly complex society but our humanity has not changed.

Today, many of our nation’s hospice and palliative care professionals will care for someone who will end his or her life’s journey. They will be there for them, and comfort their families as they say a final goodbye and grieve their loss. They will care for them with the professionalism and compassion that are hallmarks of hospice and palliative care; the mission to serve others will not be diminished or hampered.

Many providers will make the services of bereavement professionals and grief counselors available to the broader community that will need a place to explore the wide range of emotions and loss they are feeling. It is important that hospices remind their communities that they are an important resource with the skills to help those who are grieving and coping with loss.

Yesterday’s events affect us. We should allow ourselves time to process what we are seeing and hearing via ongoing newscasts. We are reminded to be attentive to our children and monitor what they may be seeing on the news or on the Internet. Let us also support those heroes who respond in such emergencies and lend an ear to our friends and neighbors who may need to share their fears or concerns without judgment – particularly from our loved ones and neighbors who are part of the LGBT community.

It’s also an important time to take an extra moment to tell those near to us that we love them. 

National Hospice and Palliative Care Organization
Alexandria, VA



Friday, June 3, 2016

Using Metrics for Marketing

http://www.nhpco.org/resources/nhpco-edge

If I could offer one key to getting your foot in the door with potential partners and referral sources, it would be, “know your metrics.” Don’t just tell the local health system that you provide great hospice care and your patients love you. Tell them that you can prevent those patients from bouncing back into the hospital or ER. And then prove it.
 

You can use your own patients’ histories to make the case. Gather aggregate statistics on your patients’ hospital admissions or ED visits in the period prior to hospice admission. You may cover the 30, 60 or 90 days prior to the hospice admit; then look at their care patterns afterwards. Be sure you know what percentage of your hospice patients are admitted to a hospital while on service and break it out by diagnosis, so you look closely at those diagnoses that we know are highly likely to run the risk of readmission. In particular, check hospital utilization for patients admitted to hospice after hospital admissions for COPD, CHF or stroke. 

One key measure that will pique the interest of ACO referral sources is the overall cost of care for your patients. ACO shared savings targets depend on reducing the total cost of care for the lives assigned to the ACO, regardless of where that care is received. If you can demonstrate a mean Medicare payment per admission that’s lower than your competitors, you might consider sharing that information with the leadership of the ACO with whom you seek preferred status. You may be able to get that comparative data from your state survey of hospices, or from one of the national hospice data analytics firms that gathers Medicare claims. 

Consider external sources of data as well. If your relationship with the local health system permits, you may be able to run a cooperative study, drawing from their inpatient data to find out which diagnoses and which patients are creating avoidable costs to the system. And don’t forget to check the CMS consumer site, Hospital Compare. That site shows rates of readmission for several key diagnoses, and how well each individual hospital is doing at meeting targets for avoidable readmits. 

Be imaginative and try to see through the lens of your referral partners’ needs. If hospice and palliative providers are truly to take a seat at the table, we need be seen as the problem solvers we are.

Sue Lyn Schramm, MA
Director, Consulting Services, NHPCO


See the previous NHPCO Edge Blog article, "The Gentle Art of Teaching Hospital CEOs."