Forth Worth, Tex.-based Community Hospice of Texas and Providence Hospice is collaborating with technology firm Turn-Key Health, a subsidiary of Enclara Healthcare, to form a new community-based palliative care program to serve members of Medicare Advantage plans.
Through the partnership, Community Hospice is leveraging Turn-Key’s Palliative Illness Management (PIM) application, which uses predictive analytics to help identify health plan members who are eligible for palliative care early in their disease trajectory, as well as providing support from nurses and social workers who can assist in guiding care plans, health plan member engagement and care management.
Victoria Jingle, CEO, CHOT, says, “As a progressive healthcare organization, we recognize this as an opportunity to facilitate better coordinated care for the Medicare Advantage plan members in the 25 counties in the North Central Texas area,” said Victoria Jingle, CEO of Community Hospice of Texas. “Our entire organization is excited to collaborate with Turn-Key Health because it provides us with an opportunity to engage sooner with community members who can really benefit from the expert palliative care we provide for our patients.”
The PIM includes structured processes, embedded work flows and assessments to support care. The predictive analytics system analyzes Medicare claims and encounter data to identify health plan members who would benefit from palliative care, who are at risk of experiencing preventable hospitalizations, intensive care unit admissions and emergency department visits.
The system tracks health care members longitudinally, capturing specific palliative care information and provide integrated palliative assessments for nursing and social work to help reduce the incidence of unplanned care, recommending different levels of intervention based on health plan member needs.
In addition to the technology platforms, the system includes deployment of nurses and social workers to review the data and help guide interventions, care planning, and provide health plan members with additional support.
Early identification of patients in need of palliative care or hospice can help relieve patients’ suffering, enable support for family caregivers and reduce health care costs.
“If you look at the last six to 12 months of life in general in the United States you have at least 50% of individuals who represent high persistent spend, receiving really expensive care, not getting great direction, probably dealing with multiple morbidities,” Greer Myers, president, Turn-Key Health, told Hospice News. “It’s high-cost acute care, often in an out of hospitals, and then you have this hockey stick effect during the last six months of life where everything escalates. We are engaging with payors, we are engaging with the hospice and palliative care companies in the geographies that we have identified to reduce preventable high-acuity care, and it’s all about moving the patient back in the home.”