The National Partnership for Healthcare and Hospice Innovation (NPHI) has named its new board chair: Samira Beckwith, president and CEO of Florida-based hospice provider Hope Healthcare. As Beckwith told Hospice News, value-based payment models will be a primary focus in 2021 and beyond as the future of end-of-life and serious illness care evolves and a crowded field becomes more competitive.
NPHI is a national advocacy organization made up of more than 70 nonprofit hospice, palliative care and advanced illness providers who collectively serve more than 121,000 patients and families daily across the country.
Beckwith has been at the helm of Hope Healthcare for more than 30 years. Through her leadership, the organization grew from a hospice caring for fewer than 100 patients a day to a comprehensive, community-based health care system with a daily census that exceeds 4,000 hospice, palliative care, PACE, and pediatric patients. Hope also offers Parkinson’s disease-specific programs as well as services to address social determinants of health.
Beckwith has served on the White House Conference on Aging (WHCOA) and has appeared as a subject matter expert before the Senate Special Committee on Aging and the House Judiciary Committee. Beckwith has also served as chairperson for both the National Hospice & Palliative Care Organization (NHPCO) and the National Hospice Foundation. She is also the founding president of the Florida Program of All-Inclusive Care for the Elderly (PACE) Providers Association, past president of the Florida Hospice and Palliative Care Association, and a founding director of NPHI.
Beckwith’s firsthand experience as a patient needing serious illness care at a young age helped to inspire her career. She spoke with Hospice News about her 2021 priorities as board chair and as a CEO: Improving the quality of care nationwide and helping NPHI members navigate new value-based care initiatives.
What led you to the serious illness care field?
When I was 24, I was diagnosed with Hodgkin’s disease and I feel blessed because I survived a very serious illness. Back then, people often did not survive Hodgkin’s disease. Today, there’s much more treatment for it than what I had for it. It was through that experience that I had an inside look at the health care system and how the system really did not allow for the best care possible for people who had serious illness.
I realized that there were really good doctors, nurses, social workers, lab technicians and people who really cared, but there was not a way to be sure that the communication was what it needed to be and that people had the best care possible. Being lucky to have survived and have had that experience of being with so many other people who had serious illness.
At the same time, there was this discussion in the country about an idea called hospice. I decided then to be a part and see what I could do to help assure that people had the right care at the right time and the best care possible.
What led to your interest in this role as the new board chair for NPHI?
I have been passionate and involved in assuring that people have the care they need during the closing chapter of their lives for more than 40 years. We have to help to shape the future as well as to live in the present, which is why I’m so interested in serving as chair of NPHI.
I was actually a founding member of NPHI and served on the originating board of directors. Our first board chair, Phil Marshall, has done a wonderful job. He is now retiring from the hospice world, and I was really honored to be selected as the new board chair. To me, the work that we do is to assure the continuation of legacy, community-based organizations and the future of hospice care and health care in this country. It is critically important not only to Hope Healthcare, but to my colleagues that are NPHI members.
What do you see as the most pressing concerns facing hospice providers in 2021?
One of the most pressing issues is to assure that hospice care continues as a type of care that is not diluted and continues to make a difference for people, for families and for communities.
I believe we really are at a critical juncture in the health care delivery system. There are so many new valued-based payment systems and a lot of resetting of the entire health care space going on. There’s a lot of competition, and this could result in hospice being limited to brink-of-death care, instead of hospice as we’ve come to understand it.
With all of this pressure on the health care system, [hospice providers] need to be sure that we’re a part of the future.
How do you think the advent of the value-based payment models for hospice this year will affect non-profit providers?
Without the proper guardrails and safeguards to assure hospice care delivery proceeds as it should be, then payers and other providers may dilute the hospice benefits or dilute them to a minimum standard. I don’t think at this point there’s enough safeguards in these new value-based care ideas that are developing to assure that hospice care does not become medicalized and just another department of the health care system. It can’t be provided as an a la carte service, it’s got to be provided as part of the movement.
Hospice really makes a difference for the family who can go on knowing that they did all they could do for their loved one. The ways that we relieve that suffering is really important.
There could very easily be financial pressure in value-based payment models if a payer doesn’t understand the real outcomes. There could be pressure to only pay per-visit instead of understanding that hospice is a unique bundle that makes a difference in coordinated care.
Will Hope Healthcare be participating in any of those models?
We are participating in as many payment models as we can to be sure that our voices are heard and that we have an opportunity to help shape the future. If you don’t have that opportunity, you can be completely left out.
We’re one of the six hospices participating in Advanced Illness Partners (AIP). The individual, community-based hospices like Hope Healthcare and other founding members were not part of a large corporation with multiple sites. AIP is a collective effort of our like-minded hospices that can come together and participate in some of these programs that will help shape the future of hospice care.
Hope Healthcare has entered into a joint venture with other NPHI members called Advanced Illness Partners. What is the mission of that enterprise and what does it offer to members?
It’s an opportunity for us to come together and be able to participate in some of these new models that are being evaluated, so that we could have some say or some opportunity to influence how they’re going to look. It’s a way to share that collective knowledge, wisdom and skills to be a part of some of these models that are being tested. We want to be a part of shaping that outcome.
What are some other issues that NPHI is currently focusing on, and what will be the board’s approach to navigating those?
One of the points that we’ve talked about was the fact that collaborating gives us an opportunity to assure quality and help to set the standards, because if we can help define that standard, then it’s more difficult for others to dilute it. With that clarity, we can help regulators and legislators, as well as community members, to keep that standard of care and not allow the medicalization or the dilution of hospice care.
Unfortunately, too many regulators and legislators are trained to think that hospice care for people in the last two weeks of life, which it shouldn’t be. It should be the closing chapter of life. I’m actually getting away from saying “end-of-life care.” It is care for advanced and serious illness. It’s when the focus of care shifts from being curative to comfort. If we can move in that direction, then many of these [value-based] programs trying to develop aren’t even needed. We just need to allow hospices to take care of people, and we have that skill.