Internal Assessment Helps Hospices Grow Footprint

For hospices looking to grow, a careful look at where they are now can help them choose the right pathway to expansion. Careful assessment of current financial and operational status, as well as the needs of their community, can inform the strategic planning necessary to build an organization’s scale.

Growth opportunities presently abound in the hospice space, with positive tailwinds such as rising demand and favorable demographics buoying the market, as well as a thriving mergers and acquisitions marketplace featuring record high valuations, joint venture activity, and rising private equity interest in hospice.

To capitalize on these developments, hospices start by looking inward.


“It’s extremely important to examine your program from head to toe,” said Wayne Regan, director, Simione Healthcare Consultants, in a recent webinar. “All organizations need to perform a deeper dive, a truthful analysis of your geography, your competitors and your opportunities, as well as evaluating your strengths.”

Regan recommends beginning with a comprehensive Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis, that considers community needs that could support growth, referral management, as well as operational strengths and weaknesses.

Key factors to consider in your SWOT analysis include data about death rates and hospice utilization in your service area, your Hospice Compare scores, evaluation of any specialty programs, other services offered such as palliative care or pediatric hospice.


The SWOT should also include a competitive analysis and examine your potential weaknesses, such as any recruitment or staffing issues, nursing turnover, any quality concerns, such as how quickly your hospice makes initial contact with patients, as well as any performance issues among your partners or subcontractors such as the pharmacy or durable medical equipment providers, Regan explained in the webinar.

“An internal SWOT gives leadership a perspective on how you can proceed,” Regan said. “Does your organization have a true, fully capable hospice care delivery model that complies with all [Medicare Conditions of Participation] and often goes above and beyond? Are you strong in nursing; are you strong in social services? Do you have a fantastic volunteer base that is always available? Do you honor veterans?”

To assess community needs, data collection is necessary, according to Lisa Lapin, principal for Simione. The hospice will want to know who the referrers are in their service area or the area to which they want to expand, as well as their competitors, death rates and hospice utilization in the regions.

Sources for these data include U.S. census information, Medicare Payment Advisory Commission reports, public use files cost reports, as well as data from national and state associations and data vendors.

“It’s really important to know your market; the [community] needs assessment helps with the big picture, and then you also need to be savvy about your competitors,” Lapin said in the webinar. “You need to know if there are unmet needs among your patient population, or if your market is saturated. If there is market saturation then your efforts need to be focused on capturing more of your market or expanding into new territory.”

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