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