Hospice of the Western Reserve Boosts COVID Resilience Via JVs, Partnerships

After hitting some financial setbacks due to the COVID-19 pandemic, Cleveland, Ohio-based Hospice of the Western Reserve plans to leverage joint ventures and collaborative partnerships to fuel growth.

Hospice of the Western Reserve is among the many hospices nationwide that has been pummeled by financial blows of the coronavirus pandemic. Economic fallout from COVID-19 was among the contributing factors that led to Western Reserve’s decision to reduce staff and close doors of the company’s inpatient unit affiliate, Hospice of Medina County (HMC), in June, 2020.

Roughly 97% of the facility’s care was provided in private residences, nursing homes and assisted living facilities. The two merged in 2015 to expand patient and caregiver services in the area.


While Hospice of Medina County continues providing home-based hospice services, President and CEO Bill Finn told Hospice News that the inpatient closure was a “particularly painful” decision. Finn, who is also board chair of the National Hospice Work Group and serves on the executive committee of the National Partnership for Hospice Innovation, stated that advanced illness management partnerships will lend to the hospice’s future growth.

“We’re looking at advanced illness management partnerships with different hospitals,” said Finn in a recent podcast from hospice law firm, Husch Blackwell LLP. “We actually had the opportunity to work with one of our health systems here that has been a competitor and wanted to improve the quality of their hospice program and be more effective financially. They came to us and we have created a joint venture for them.”

Hospice of the Western Reserve entered into a joint venture with University Hospitals in 2019, expanding hospice and bereavement services throughout both organizations’ service regions. The partnership was intended to provide a continuum of individualized services for patients and their families, according to a statement.


“We now have the stand-alone joint venture with that health system where we turn key all the hospice, palliative care and home-based palliative care for that system,” Finn said. “That joint venture has been up for well over a year now and has been quite successful. It was an innovative way of trying to deal with health systems needing to have some skin in the game and not simply wanting to use a community partnership.”

The hospice provider serves 1,200 patients daily across nine counties throughout Northern Ohio. Demographic tailwinds could lead to burgeoning opportunities in the hospice market and beyond throughout the Buckeye state. Ohio ranks sixth among the states in hospice utilization, with 56.7% of Medicare decedents electing hospice in 2018, according to the National Hospice and Palliative Care Organization. The national average is just above 50%.

Additionally, more than 17% of the state’s population were 65 and older in 2019, according to a U.S. Census Bureau report. Based on the bureau’s projections, the Ohio Department of Development reported that the state will see an increase of 849,000 people in this age bracket from 2000 to 2030.

Merger and acquisition opportunities are part of Hospice of Western Reserve’s multi-pronged approach for expansion, according to Finn. The organization anticipates growth in part due to new partnerships and networking collaborations.

“Because of the environment we’re in, we are going to have to look at creating partnerships and links that allow small, medium and large hospices not only to survive but to thrive,” said Finn. “We are structuring ourselves to be able to support smaller nonprofit hospices in a meaningful way that allows them to continue to support local communities,” said Finn. “Through the Care Solutions Network of Ohio, we are providing the structure to do everything from [value-based insurance design (VBID)] to [Centers for Medicare and Medicaid Innovation (CMMI)] work. We’ll come at that as one unit and negotiate that contract. We’ve also created a company that will have an MCL function and will sell back-office services to smaller hospices.”

Hospice of the Western Reserve created Care Solutions Network of Ohio in collaboration with its parent company, Western Reserve Care Solutions. Through the network, the hospice provides back-office services to smaller not-for-profit community-based hospices in Ohio such as physician contracting, on-call support and educational and technological resources.

“I constantly look at creating the synergies that drive down my cost of care, but at the same time improve the patient outcomes, the patient satisfaction and allow us to really provide something that puts us leaps and bounds above our competitors,” said Finn.

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