Collaboration with Hospice Caregivers Boosts Family Satisfaction

Keeping family members engaged in the course of a hospice patient’s care, including care planning, can improve patient and family satisfaction. Patients and referral partners are increasingly examining publicly reported satisfaction scores when selecting the hospices they want to work with.

The Consumer Assessment Healthcare Providers and Systems (CAHPS) survey is one of the most important sources of data on hospice quality. The U.S. Centers for Medicare & Medicaid Services (CMS) requires hospices to give the survey to families following a patient’s death to gauge their satisfaction with the services they’ve received. The survey’s questions indicate family perceptions of hospice performance on 11 metrics such as patient and caregiving training, hospice team communication and emotional and spiritual support.

“Our satisfaction scores in hospice are directly impacted by the way we communicate with our patients and our families,” said Maureen Kelleher, clinical consulting manager at BlackTree Healthcare Consulting during a recent Hospice News webinar. “The scores actually improve when you include families. Finding ways to communicate with them in real-time or include them in the process before decisions are made is critical.”


Reported on CMS Hospice Compare site, CAHPS patient and family satisfaction scores are having a tectonic impact on decisions around end-of-life care. A growing number of patients and families are using this publically reported information when choosing a hospice. Referring organizations such as hospitals, nursing homes and primary care physicians also use quality data to guide referral and contracting decisions.

Patient experience and perceived quality of care will be additionally important to sustainability in evolving payment models taking effect in 2021 as CMS tests a hospice carve-in for Medicare Advantage plans. Payers will be looking closely at quality scores as they weigh contacting options with hospices, as could Accountable Care Organizations.

Getting families involved in the care planning process has been challenging for hospices with the need to socially distance during the novel coronavirus pandemic. Keeping families engaged as COVID-19’s spread continues will remain a focus for hospices looking to improve the experience and quality of patient care.


Communication could be a key to achieving clinical excellence and supporting CAHPS satisfaction scores. Family caregiver satisfaction with an organization’s communication can make or break a hospice’s performance. Research from a survey conducted this fall by Citus Health showed that high engagement with family caregivers improves their satisfaction, with roughly 80% indicating they would select a hospice for a loved one based on timely communication.

“[People] want a provider that can communicate in a real-time format and that they’re accustomed to in other aspects of life. It makes sense that they would feel more taken care of during the toughest time in their life,” said Melissa Kozak, co-founder and CEO of Citus Health, during the webinar. “It’s really a no brainer for hospices to invest in modern technology that enables real-time communication. Like other consumer categories, hospices need to communicate with their consumers in a way that’s most comfortable for them. Technology can directly lead to better perception of hospice.”

Hospice providers have strained to support caregivers from a distance during the novel coronavirus pandemic have leveraged telehealth to remain connected with patients and their families. Technology has become crucial to the ability for families to keep in touch with interdisciplinary teams of clinicians, nurses, social workers and case managers.

Many hospice providers have invested in remote patient monitoring systems, virtual care/video call platforms and electronic medical recordkeeping capabilities as telehealth expands. With apparent plans to make the temporary regulatory flexibilities permanent, reaching family caregivers virtually could help stoke patient and family satisfaction with hospice telehealth care.

“It’s really important now more than ever to innovate,” said Stan Massey, partner and lead consultant with Transcend Strategy Group. “If you are in touch constantly, if you are able to respond more quickly, if there is a situation in terms of helping manage family and patient expectations, then there could be a very direct and quick response.”

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