Hospice providers need to evolve with their changing patient populations and the larger health care system, according to Greg Hagfors, CEO of Partners In Care.
The Oregon-based hospice, palliative care and home health provider recently celebrated the 45th anniversary of its founding, which preceded the establishment of the Medicare Hospice Benefit. A group of volunteers had brought the hospice concept from the United Kingdom to Oregon, according to Hagfors. Since then, the company has grown in terms of census, grown more sophisticated in its approach to end-of-life care and expanded into other business lines.
A 35-year health care veteran, Hagfors has led Partners In Care for more than two years. The organization serves a predominantly rural population in the central portion of its home state.
Hospice News recently spoke with Hagfors about the ways the industry has changed since Partners In Care came on the scene — and how it is moving towards the future.
You mentioned a lot has changed for Partners In Care over the years. Looking at the macro level, what would you say are the biggest changes that have occurred in the hospice space since your organization came on the scene?
The industry as a whole is evolving and incorporating much more for-profit businesses than it has in the past. It has historically been nonprofits that have dominated the market, and now there are more and more for profits entering hospice care. That’s certainly something that is very prevalent going on across the country.
As an industry, we’re looking to diversify our portfolio of services in a way that is somewhat complementary, but yet does have some diversification of the revenue stream that we have with just hospice. Partners In Care has done that well with home health care. Our home health care census is actually larger than our hospice census at this time.
We measure the score at Partners In Care by how well we do with patient care, and we call it a victory when we were rated five-stars by [the U.S. Centers for Medicare & Medicaid Services (CMS)], and we have that distinction in the hospice arena. We do everything we can to maintain that level of service that we have for our patients and their families.
Regarding the diversification aspect, you mentioned, you’ve launched palliative care and home health. Do you anticipate further diversification? Are there other kinds of business lines that you’re looking at currently?
Yes, I do anticipate that. We’re embracing them as we can, as we can do them well. But I do anticipate that we will have other services that we’ll be involved in going forward.
And where do you see the most significant opportunities and headwinds looking ahead in 2024?
I think Partners In Care as an entity has the ability to be much more efficient than we are today. And as such, we are working on implementing a new electronic health record. It will make our clinicians job easier, and I think it will help leadership avoid “DUDs” — decisions unencumbered with data.
We can’t get all of the information necessary to make good decisions with just financial data. We need to incorporate a lot of the clinical information with the financial information to make good decisions. That’s what our goal is really with the electronic health record, to provide us with a new platform that’s going to give us the information necessary to help us make better informed decisions and make our clinicians job easier.
The other thing we’re doing that I think is going to be meaningful for us and for our patients is that we are partnering with our pharmacy provider, Delta Care Rx, and creating an onsite pharmacy here. We have a shortage of pharmacy services here in central Oregon. An onsite pharmacy here that will be tailored towards hospice patients that will enable us to get medications quicker for our patients and get that as streamlined as possible for patient care.
That’s a big problem for us in our service area, and that ultimately will be available to all the other hospices in our service area as well, just to improve care overall.
We’re in a pretty rural area, and the pharmacy issue is a pretty significant one. Like many other organizations, they’re having trouble with staffing. And so there’s a lot of pharmacies that are closed or not operating usual hours or just having issues with filling prescriptions on time. And so I think this will be a huge win for our organization, for the staff.
It’ll be a pretty big win for Delta Care, because I think it’ll be their first location on the West Coast.
What’s next for your palliative care program? What are your plans for your palliative care business in 2024?
We have a unique palliative care relationship with the large, multi-specialty group practice in our market. And we have embedded palliative care, including the physician, nurse practitioner and chaplain within the clinic, and they work with complex patients with multiple diagnoses.
It used to be where it was just embedded in oncology, but now they take care of nephrology and cardiology patients, and pulmonary patients that have multiple diagnoses, and then we contract with them to serve that patient population.
We also do home palliative care, and that is a big part of our business. I think that the big thing that’s happening in Oregon is that the Medicaid population will be eligible for palliative care benefits. And so we’re working with our local clinical care organization in our part of the state to figure out a value-based reimbursement model for palliative care, which will become effective January 2025.
Earlier you spoke about compassion fatigue among hospice workers, and I’m wondering how you seek to address that within your staff? How do you tackle that problem?
Our number one strategic goal is to be an employer of choice. We truly believe that if we take great care of our employees, they’re gonna take great care of our patients. And really great, quality care is good business as well. So it kind of has a trickle down effect.
We have a culture of being servant leaders, and we have our non-clinician people, our administrators, trying to understand what our clinicians do and make their job as easy as possible and make work as enjoyable as possible.
We have received a wellness grant for a large portion of our workforce, that is intended to help us with that compassion fatigue and burnout. There’s a whole number of things that we’re doing, a lot of it around education we offer with different courses and different speakers.
For the workforce, it starts with taking good care of yourself as a clinician, and we’re trying to instill that in our culture and do that the best we can.
