As 2021 approaches hospice providers are contending with a massive second wave of COVID-19, with the numbers of cases and fatalities escalating each day. Despite promises of a vaccine on the horizon, predicting when the pandemic will end remains impossible. For this reason, VITAS Healthcare CEO Nick Westfall says that his company is planning for COVID to continue for the long haul.
VITAS, the hospice subsidiary of Chemed Corp. (NYSE: CHE), is the nation’s largest hospice provider in terms of market share. Westfall recently sat down with Hospice News at the Elevate conference to talk about the ways COVID-19 has impacted VITAS and the company’s plans as the pandemic continues.
“All of our forecasting, all of our planning is as though the pandemic is not going to end. We’re operating yesterday and today in exactly the same way that we anticipate at least through the first half of next year,” Westfall said. “It’s continually ensuring we have more than adequate PPE levels. We recognize [staff] burnout is going to be real and support one another. We don’t know how long the tunnel is going to be, but we’re planning as though this pandemic is going to be with us for a long time [and] navigating through to where there is a light at the end of the tunnel.”
To date, more than 11 million people in the United States have become infected with COVID-19, leading to nearly 250,000 deaths. The pandemic has also taken a huge financial toll on hospices. According to recent research by the National Association for Home Care & Hospice (NAHC), 60% of the hospices surveyed anticipated a decrease in annual revenues during calendar year 2020. A majority of the providers cited increased costs of supplying staff with personal protective equipment (PPE) as a driving force, along with increased demand for paid leave, investments in telehealth and other costs.
VITAS brought in $337 million in net patient revenue during the third quarter of 2020, representing a 4.8% increase over the prior year’s quarter. The company saw a 4.7% rise in admissions, but a slight decline in average daily census of 0.2%.
Westfall said VITAS pandemic response focused on five key areas: employee and patient safety, additional employee support through increased paid time off and merit adjustments, prevention of layoffs or furloughs, continued growth, and work to differentiate VITAS to referral partners in the markets they serve.
“The pandemic is another illustration of a stress test on all organizations across the country,” Westfall told Hospice News during the conference. “Change is always happening around us, but the thing the pandemic really reinforced is the need for flexibility every day. As rules, regulations and federal, state and local interpretation of those things change, flexibility absolutely is one of the biggest lessons learned.”
A key flexibility that emerged during the pandemic was the swift and widespread leveraging of telehealth.
Rules and regulations around telehealth are anticipated to be an anchoring factor for hospices to continue reaching patients and their families even after the coronavirus pandemic passes. Regulatory action from the U.S. Centers for Medicare & Medicaid Services (CMS) relaxed requirements that expanded the use of telehealth during the public health emergency, with hospice providers increasingly utilizing virtual platforms to extend patient care and family support.
Telehealth has been an avenue for staff to access patients in the home or community-based settings, along with those in hospitals and skilled nursing or long-term care facilities that have closed their doors during the pandemic. Telehealth has additionally allowed for more flexibility for staff scheduling as the hospice workforce becomes more remote, eliminating the need to spend time and expenses on traveling for patient care.
Telehealth is anticipated to continue growing following the COVID-19 pandemic, with Medicare Advantage plans as one engine for growth according to HHS Secretary Alex Azar. Expansion of telehealth services across the health care continuum is likely to shape the coming years of health care, including for hospice and palliative care. Positive patient perception and acceptance of telehealth care has further fueled its widespread use.
As the need to socially distance continues, expanded telehealth utilization may contribute to further growth of community-based care as more providers delve deeper into remote services for patients and their families, even as the pandemic drives more health care into the home setting. Without an end of the pandemic in sight, providers nationwide are straining to see beyond 2020’s crest and into the coming year.
“The pandemic has allowed for us to think about ways to deliver and receive care at home that maybe the patient wouldn’t have necessarily thought about,” said Westfall. “It’s really rerouting the delivery of care. We have always seen telehealth as a real value-added compliment wrapped around the provisioning of care. For patients and families, it’s just turned out to really be very beneficial to them.”