Health Systems Still Don’t Get Hospice

Hospitals and Health Systems still don’t get hospice! I am working with several hospices that are trying to forge deeper working relationships with their local hospitals. Hospice can be such an important tool in:

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  • Decreasing their Mortality Stats (the actual number and related Length-of-Stay)
  • Maximizing their DRG payments
  • Reducing inappropriate hospitalizations
  • Creating a new stream of revenue

Has anyone else experienced these challenges?

To some degree I understand this, having worked in a large complex health system for 16 years. While many hospital/health systems espouse system thinking that drives their behavior, you would be hard pressed to see that in action. Case in point, hospitals have a hard time of collaborating with hospice. Why? Who knows, but hospitals are working extra hard to develop their post-acute care continuum.

Here is a little case study. This one hospital has a Mortality LOS of 8.8 days. The LOS on all the hospice referrals made were 8.2 days. These two metrics in and of themselves you would think would capture the hospital executives attention. We tried to use this data as a respectful call to action and set up a meeting to have a dialogue.

After several attempts and many months we finally were able to secure a meeting with the CEO, CFO, CNO and CMO. Our objective was to establish a more collaborative (not exclusive) working relationship. We started our meeting by getting a better understanding of how the group perceived the data we shared with them. To our amazement, this was new information. And of course they didn’t totally believe our data (which actually came from them). Our dialogue then turned to specific programming we could offer to assist with both their mission and business objectives. We proposed the following:

  1. Implement a GIP Scatter bed program.
  2. A Hospice Emergency Department Diversion program
  3. An ICU Collaborative Education program.

What amazed me the most was instead of being interested in how these programs could help, the C-Suite folks gave reason after reason why the timing was not right. These are relatively simple programs. This is one example that unfortunately plays itself out with far too many hospitals I work with.

There was a silver lining, however, as we were able to identify a physician champion who was instrumental in helping the hospital recognize how hospice could help. We were able to implement the programs listed above with the result after a year being:

  1. Mortality LOS declined to 5.1 days.
  2. Hospice referral patients LOS declined to 5.5 days.
  3. $72,500 in revenue from the GIP Scatter Bed Program.

Has anyone else out there have a story to share?

The Best

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