Hospice providers have increasingly adopted predictive analytic systems to identify patients in need of their services further upstream in their disease trajectory, as well as to demonstrate their value to payers and referral partners, including Medicare Advantage plans. The U.S. Centers for Medicare & Medicaid Services (CMS) will begin allowing hospices to participate in Medicare Advantage in 2021 with the value-based insurance design demonstration project.
Hospices have progressively leveraged predictive analytics to reach patients earlier. These emerging technologies have given providers tools to better analyze the data they collect through routine visits such as blood pressure, weight, heart rate, blood sugar and oxygen levels. These predictive monitoring tools can help hospices remain competitive in a crowded market.
“Predictive models attempt to anticipate future outcomes or behaviors based on data about what’s happened in the past to predict what is likely to happen in the future,” said John Dickey, COO of Acclivity Health Solutions, a technology platform provider for post-acute care settings. “Many predictive models do help identify patients at high risk for hospital admission/readmission. The metric is generally presented as a percentage of likelihood that an admission or readmission will occur within a specific time frame, for example,three, six, or 12 months. When used in combination with other patient information and/or predictive metrics, providers, including hospices, can take appropriate steps to intervene proactively and prevent the would-be admission from occurring.”
While hospice utilization is rising, lengths of stay for many patients remains too short for them to receive the full benefit of hospice care. Hospice utilization among Medicare decedents exceeded 50% for the first time in 2018, according to the National Hospice & Palliative Care Organization (NHPCO). More than 27% of patients in 2017, however, were in hospice for seven days or less, with another 12.7% in hospice for less than 14 days, NHPCO reported.
Many hospices are increasingly investing in technology platforms to set themselves apart from competitors in their geographical regions. Strong demographic tailwinds continue to drive hospice business in regions throughout the country, with hospice utilization continuing to climb in states such as Utah (59.4%) and South Carolina (more than 50%).
Hospice Care of South Carolina/Agapé Hospice recently became among the first in its state to implement predictive modeling technology, announcing the adoption early this month.
“It was our goal as an organization to become an innovator in the hospice space,” CEO Troy Yarborough told Hospice News. “We wanted to leverage advances in technology, drive support and enhance our care by empowering our employees through Muse Healthcare’s predictive modeling technology. It helps predict a transition of a patient’s recent change or erosion in condition. The predictive component is more of a risk stratification or early warning system. It allows us to reassess the patient and help us make sure that our resources are pointed to where the need is greatest.”
Using machine learning tools allows hospice providers to adjust care plans and visit frequency by tracking a patient’s progression. Identifying patients in need of end-of-life or palliative care services earlier in the course of their illnesses and tracking outcomes will be important when hospices begin to negotiate rates with private payers in 2021 when the Medicare Advantage hospice carve-in rolls out.
“When hospices leverage data and predictive modeling to guide care and to report outcomes, they’re in the driver’s seat when it comes to negotiating with payers and rising above their competition,” Dickey told Hospice News in an email. “As palliative and other advanced illness programs continue to gain recognition, including through the Primary Care First-[Serious Illness Population] program and the Medicare Advantage hospice carve-in, hospices will need to prove the value of their programs, both individually and relative to their competitors, to maintain and grow census.”
Hospice providers are using the technology to improve performance on key quality measures such as increasing patient visits towards the end of life.
“We’re able to help point clinicians towards those patients who may need incremental levels of care sooner with this technology,” Yarborough said. “At its core, this means a dramatically different experience for the patient and the family. We’re now able to adjust our care plan, our visit frequency, the disciplines that are seeing those patients, and ultimately work towards the best possible transition experience for our patients. It adjusts the paradigm of our hospice and the relationship with our patients and their families and satisfaction begins to grow and communication begins to grow, our providers feel that it truly empowered them to make supportive decisions that improve the care delivery to the patient.”