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Female nurse holding male patient smiling

The recent American’s Health Insurance Plans (AHIP) conference was full of insights and opinions. In our ever-changing healthcare system, providers must understand the mindset of payers to stay ahead of the “new” value-based care curve.

The theme: “New Perspectives in What’s Next in Health Care” looked promising so off I went to San Diego. The conference didn’t disappoint, with speakers ranging from the new CEO of the Amazon-JP Morgan-Berkshire Hathaway venture Atul Gawande to President George W. Bush and numerous short but impactful sessions, I came away with the validation that hospice providers have had it right from the beginning.

We are “value-based, person-centered care” personified. Enacted in 1983, the Medicare hospice benefit was the first capitated (value-based) payment model embraced by Medicare, paying providers a single rate to provide complete, integrated, multi-disciplinary care for patients until the end of their lives.

For 40 years, Hosparus Health has been one of the largest not-for-profit hospice organizations in the nation, caring for over 1,200 patients-per-day in 37 counties in Kentucky and Indiana. We serve as a crucial safety net for the sickest, most vulnerable patients in the communities we serve. As a mission-driven healthcare provider, we are continually committed to improving access to the highest-quality advanced illness and end-of-life care.

So when I attended session after session listening to payers talk about how they are working to “build a system designed to meet patients’ needs,” I sat there thinking: “helllooo, look at us, this is what we do, it’s already created, just tap into the proven method of patient care and imagine how many lives we could improve and imagine how much money we can save the system.”

It’s really a no brainer, right under the nose of literally every payer in the country are nonprofit hospice and palliative care providers whose mission has always been to wrap our “value-based” services and complete interdisciplinary teams around patients and families to provide the most compassionate person-centered care until their very last breath.

And now, we continue to wrap our services around patients and families but upstream from hospice care. Many hospice providers have begun to roll-out their own innovative models of advanced illness care upstream from the hospice palliative care programs as part of their service menu and in partnership with local hospital systems and payers that see the value in providing person centered care to the most seriously ill.

Advanced illness care/palliative care is shown to reduce hospital readmission rates and frequent ER visits for disease symptom management. While hospice is not a substitute for advanced illness care, these programs can feed into a quality hospice program that provides compassionate care at the end-of-life. By providing the same model of care to patients with an advanced illness while they continue treatment, we are better able to manage their pain and progression of their illness much earlier.

Discussing hospice care is often meant with “I am not ready to give up,” and while we know that providing hospice care is not about giving up but about compassionate pain and symptom management, respite care, grief counseling, spiritual care and so much more, we also know that introducing the same care approach much earlier in one’s chronic illness journey will have lasting quality outcomes for both the patient and their family, not to mention also lowering healthcare costs.

It was nice to see that the payer industry is beginning to embrace our model of person-centered care. A broader understanding of the benefits of interdisciplinary medicine as early as possible to help manage a chronic illness is the healthcare game changer that we’ve been practicing for 40 years. I am hopeful that organizations like ours will have a seat at the table with payers nationwide ready to engage hospice providers in the design of this new payment model.

On a side note, besides the conference, an invigorating part of the trip was running the San Diego Convention Center steps…as an avid stair climber, this was heaven. I may have to find another conference in San Diego just to do Step Climbing 2.0!

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