Hospices Leverage Community Resources to Address Social Determinants

A rising number of hospices are building community partnerships to accommodate patients’ nonmedical needs, allowing them to continue receiving care in the home. These partnerships support quality patient care and position hospices to capitalize on the growing recognition among payers that addressing social determinants of health can reduce health care costs and improve patient satisfaction.

Exploring opportunities to provide nonmedical services can open new revenue streams for hospices, which currently rely on capitated per diem payments via the Medicare Hospice Benefit. The U.S. Centers for Medicare & Medicaid Services (CMS) earlier this year announced that Medicare Advantage plans will begin covering supplemental nonmedical benefits in 2020. CMS will begin testing a Medicare Advantage carve-in for hospice in 2021, giving participating hospices access to those supplemental payments.

Many older adults and their families recognize that nonmedical help is necessary to maintain or improve their quality of life, but it can be overwhelming to seek out access to those services.This is where hospices can step in to offer support.


“There’s a whole population of people who are at risk for being in a nursing home. They may not yet need hospice care — they need practical help,” Christy Whitney, president and CEO of Colorado-based hospice provider HopeWest told Hospice News.

Help can involve anything from running errands to assisting with personal hygiene, or from social activities to grief education classes for patient’s families. HopeWest had these needs in mind when they began launching “The Center for Living Your Best,” a facility offering an environment for older adults seeking “lifelong learning opportunities, friendship, and support for remaining independent for as long as possible,” according to a planning document the hospice shared with Hospice News.

HopeWest will offer some of these services directly but will also foster community partnerships, creating space for mutually beneficial cross-marketing.


“If you are passionate about quality then the word is going to get out, and if the word gets out you grow volume, because there are a lot of other people out there who are in home health or hospice for different reasons,” said Cameron Muir, M.D., chief innovation officer for Capital Caring. “This commitment to the community and that reputation generates more opportunity to build scale. Scale becomes critical to leverage what you have in your operations to reach out and innovate in new and different ways.”

Falls Church, Va.-based hospice Capital Caring coordinates meal services for patients and is forging a partnership rideshare company Lyft to address patient and family transportation needs, providing rides to doctor appointments, grocery stores, pharmacies and other locations. Though some hospice patients are too sick to travel, those who have conditions with slower trajectories such as congestive heart failure or lung disease can benefit from transportation services.

“Transportation needs are greater when someone is more functional,” Muir said. “If someone can arrive at their door and take them to their cardiac or pulmonary rehab or to the grocery store, then that is something that a hospice patient absolutely can benefit from.”

Hospices can begin the vetting process for promising partnerships by seeking organizations or nonprofits with a common ground mission that meet a fundamental patient need. Financial advising, grooming services, grocery and meal delivery, transportation, legal services, and home maintenance services are a few examples.

Offering nonmedical services to senior clientele in the community, rather than strictly to hospice patients, can help create a relationship with those individuals and their families that can continue when the individual becomes eligible for hospice. Reaching prospective patients earlier in the course of their illness is an imperative for hospice providers seeking to grow.

“When you look at trying to reach all the constituencies, you have to see how you can bring [patients and clients] in before they need you, not just as they need you,” explains Whitney. “The biggest opportunity in collaboration is to become an indispensable organization to your community. If you don’t collaborate, then you’re kind of in a sea — potentially a big sea — of competition.”

Written by: Holly Vossel

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