Community Hospice CEO Phillip Ward: Providers Must Rethink Everything

To manage the changes taking place in hospice and in the larger health care system, Community Hospice & Palliative Care CEO Phillip Ward has a mantra: Rethink everything.

Ward became the top executive at Florida-based Community after the nonprofit reorganized as Alivia Care, a larger enterprise with a diverse range of business lines. Former Community CEO Susan-Ponder Stansel moved on to lead Alivia Care.

Ward, who has worked in hospice since 1992, also serves as the COO of Alivia Care.


Hospice News sat down with Ward at the National Association for Home Care and Hospice Conference and Expo in St. Louis, Missouri, to discuss how Ward and his organization are orienting to a changing industry.

Community Hospice & Palliative Care CEO Phillip Ward. Ward is also COO of Alivia Care.

Hospice News: I’m curious, how did you come to the hospice field?

Ward: Quite accidentally. I tell people within the organization that I was looking for a job and bumped into the chief financial officer in a casual setting. He was looking for people to come to join this team.


That was in 1992. And then once I began working for the organization, the mission grabbed me. I tell people that sometimes you come for a job, but you stay because of the mission.

Community is now part of Alivia Care. After that reorganization, how do you collaborate with the additional services that are being added – PACE, home health, for example. Are those available in your particular market?

I oversee all of the back-office services that are provided for all of our organizations. So I’m a part of what we’re doing in home health, PACE, hospice and palliative care.

Florida, of course, is a large market for hospice and a certificate-of-need state. What are some of the strategies that you apply to pursue growth in that environment?

The first thing that we look at is just the overall utilization rate. So when you’re looking at the number of people who die in our community, and the number of patients who are dying without hospice care, you start there. It’s a national issue for us when we’re talking about diverse communities – that they utilize hospice care at a lower rate.

So we begin with equitable access, whether you’re talking about the African-American community, the Asian community, or Native Americans. They’re all being served nationally at a lower utilization rate. 

We do a lot of outreach in those communities to help them understand the value of hospice care so that we increase the overall utilization.

Now a lot of times, people look at competition, but I actually see a larger percentage of people who are dying without hospice care than are receiving care from another provider. So we don’t focus on the other providers. We focus on how we reach out to the individuals who are dying without the benefit of hospice care. 

That’s a really interesting approach. Can you provide some additional details around some of those outreach efforts?

In our African-American community, I think one of the first things is to make sure we’re visible. We have an office in an area that is considered a part of that community, and an inpatient unit in the safety net hospital, where people are receiving care.

You have to make sure your organization is visible in that space, then engage with community leaders, faith leaders. Make sure that you’re hearing the unique perspective of those individuals and understanding any barriers to receiving hospice care.

I think it’s a multi-prong approach. Then, when you begin to look within our organization, make sure that the leaders in our organization are a diverse group. As one of our employees said to me one time, ‘I want to hear the story from a face that looks like mine.’

We make sure that when we’re in social media, or billboards, or any of those areas, that we have diverse faces that are speaking and telling our story from their unique perspective. 

Those are many of the things that we’re attempting to do to make sure that we are responsive, that we understand and are responding to the needs of those communities.

How has Community fared in the staffing arena? It’s a problem for everyone, but how has your organization fared?

It is a challenge, and we, like many organizations, have seen an increased turnover rate as individuals have made life decisions because of the pandemic to no longer be in health care. We’ve seen some of that. 

Maybe they have an elderly parent in the house for whom they’re serving as caregiver on their off hours and didn’t want to bring exposure.

We’ve seen compensation become a real issue. I think we’re in uncharted territory on compensation. We used to look at the market every two years, and now we’re looking at the market every three months because the compensation is moving.

It’s a challenge. Like so many other organizations that are experiencing this, our response has been very much to focus on the culture. We want to be a great place for people to work. And one of the things that I did was hold listening sessions. It gave every employee an opportunity to have a listening session where I asked questions about what they valued, and what are the things we’re doing right, and what are the things we’re doing wrong? 

When new employees come in, I have lunch with all the new employees and do the same thing.

I ask what attracted them to us, making sure that our reputation is still what’s bringing in and keeping people.

We did a pain-point survey where I turned it to the negative and said: Tell me what are the things you don’t love about your job. If I want you to love your job, I need to know what we’re doing that you don’t love.

We’ve created a new leadership development model to make sure that we have a baseline for all of our management, because a lot of times people will leave organizations or jobs to leave their manager.

I want to have great managers. I now have an orientation plus a certification where it’s assessment-based. Every manager, every leader, takes a test that demonstrates whether they have a competency in areas like good communication and driving results. Coaching: Are they prepared to be a coach to their people?

If they show a deficit in those areas, then I have a development module that they can take that’s broken off in a certified, advanced and a master’s level, so that individuals have the opportunity to grow their management skills. It’s also for someone that’s in the field who wants to become a manager.

Can you share more about the work you are doing at Community, projects that we have not yet discussed?

One thing I would say about recent developments, it leads me to challenge our leaders to question everything. If we are truly in a new world where there are workforce shortages and compensation challenges, then we need to look at things that we’ve done for 10 years and ask if there is a better way.  

How do I use virtual care? How do I automate the back-office processes? What should be centralized? What should be decentralized? If I’ve had a dedicated admission model for 20 years, is that still the best way to do it? This is a world where you begin to look and say that if we are in a new environment, we can’t bang our head against the wall harder.

We can’t just say, ‘I’m going to find more staff.’ If they’re not there to be found, then I’ve got to find a better way of doing things with the staff that we have. If I have to pay everyone more, I have to have fewer people. So you begin to look at those things and see what could be automated, or evaluate where technology or virtualization can help. I call it moving resources to the bedside, the most important thing that we’re doing. My ultimate adage is to rethink everything.

For 2023, it’s going to bring a lot of regulatory changes. There was a reimbursement rate that left a lot of people disappointed. Medicare Advantage is expanding. How did these factors affect your business?

A lot of those really come down to your fundamentals. What is the core? Are you strong in your core to be prepared for anything to change?

Some people describe me as an optimist. I say, I’m not an optimist; I’m a realist. My realism comes from the point of knowing there was no problem we have ever faced that we haven’t been able to solve. There have been times that we’ve had great challenges come against our organization. We’ve always been able to work through them, because of our focus on the mission.

We know why we’re doing what we’re doing. We can figure out how to respond to the environmental changes.

The Value-Based Insurance Design Demonstration (VBID) is one of those areas where I think it’s a five-year horizon.

In five years, we’re going to know how MA and VBID affects our organization. For right now, let’s make sure that we’re taking advantage of what’s in front of us and doing the core fundamentals of being a great hospice, providing a great experience providing care to our patients while being mission-driven. We can figure out the rest.

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