Hospice Providers Move Towards Addressing Social Determinants of Health

Marshaling community resources to address social determinants of health among patients and their families is the next step in the evolution of hospice care, Bill Frist, M.D., co-founder of Frist-Cressey Ventures, told Hospice News at Feb. 19 assembly of health care investors in Chicago.

Social determinants of health include patient and family demographics, access to and quality of housing, food, and transportation, as well as internet access and other socio-economic factors.

“There are ways to invest in that at the mid market. The way for hospice and palliative care organizations to accelerate that is to find a business model—really a sustainable resource model—that allows the provider to seamlessly link individual patients and their needs, as interpreted by the patient and family, to resources in the community,” Frist said. “I believe that over the next three years that model will evolve.”


Some industry trailblazers are already exploring the intersection between social factors and quality hospice care. Home Health News reported in April 2018 that Humana was expanding supplemental benefits to address social determinants and patient’s non-medical needs.

The US Centers for Medicare & Medicaid Services on Jan. 30 announced that beginning in 2020 Medicare Advantage plans will have greater flexibility to offer patients a broader range of supplemental benefits that are tailored to their specific needs, such as providing home-delivered meals or transportation for non-medical needs. Medicare Advantage will begin to cover hospice care in 2021.

Nashville-based health care investment firm Frist-Cressey Ventures, which Frist co-founded in 2007, recently invested in PurFoods, which provides meals to patients receiving care in the home, including hospice patients. PurFoods operates in 35 states and is the second largest provider of meals to patients covered by Medicaid.


Frist is a former transplant surgeon and US Senate Republican majority leader who had previously worked as a hospice medical director. During remarks at a meeting of the Health Care Council of Chicago, he spoke about the most significant trends that will shape health care during the next decade, including home-based care, expansion of community-based services, physician empowerment, and health care consumerism.

“Expansion of community-based services is the biggest trend of the four,” Frist told Hospice News. “Other than a direct referral, which most physicians can’t or don’t do, there is no community-wide assessment or inventory of the resources necessary to meet the patient and family’s needs. That is a vast space that needs to be explored. It improves care, gets rid of waste, and creates comfort out of chaos for that family.”

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