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Palliative Care News

Palliative Care Providers Leverage Data to Thrive within Value-Based Reimbursement Models

By Markisan Naso| May 9, 2023
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Data collection and analysis are becoming increasingly important to palliative care providers’ clinical and business processes.

This trend has led to many new partnerships that have helped companies make better-informed decisions for patients.

Recently, Sharon S. Richardson Community Hospice entered into a partnership with the tech company WellSky, using a predictive analytics platform to identify patients in need of palliative care or hospice earlier.

Wes Little, chief analytics officer and general manager for WellSky, said the company has seen palliative care providers like Sharon Richardson become more focused on solving the “quadruple aim” – enhancing patient experience, improving population health, reducing costs and improving the work-life balance for health care providers.

“For a palliative care provider like Sharon Richardson, the first and most important focus is on efficiency and driving financial success,” Little told Palliative Care News. “Palliative care is such a challenging business. You have to make sure that you’re centralizing all the key back-office workflows and that you’re automating as much as possible to allow your teams to deliver care as efficiently as possible.”

Among Sharon Richardson’s goals was to enhance the patient experience by streamlining communication among care teams. Little said that web-based solutions can help the Wisconsin-based provider achieve this by connecting clinicians to the same central record, which is automatically updated with data from the predictive analytics system.

Eric J. Tetzlaff, administrator of Sharon S. Richardson Community Hospice, pointed to the changing reimbursement environment as an impetus for pursuing the partnership. As value-based payment models grow in prevalence, robust data collection and analysis are becoming more essential.

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“Our bedside providers in palliative care are actively involved with navigating individual patients’ care to manage avoidable hospitalizations and improve the quality of their homebound medical outcomes,” Tetzlaff told Palliative Care News. “An electronic medical record (EMR) that can summarize and show these outcomes will be essential in the upcoming value-based health care environment.,” he said.

Providers need to demonstrate strong performance on quality scores as well as a track record of effectively preventing avoidable hospitalizations, readmissions and emergency department visits.

This is particularly the case when negotiating contracts with Medicare Advantage plans, Accountable Care Organizations (ACOs) and other value-based payment arrangements.

“[It] can help construct risk models that identify patients who need more intervention from a clinician such as a palliative provider,” Tetzlaff said. “There are also opportunities to use an EMR-based solution to strengthen triage decisions and visit frequencies to use the providers’ bedside time more effectively. This will be important to measure for ACO or shared-savings programs, with Medicare Advantage programs, and with any other collaborative partners.”

The hospice also expects to use these systems to support staff engagement and retention by boosting efficiency by reducing the administrative burden on employees. For example, Sharon Richardson’s staff can now use their own devices to document patient information both offline and online.

“From a staff engagement and retention standpoint, I think Sharon Richardson saw it as a great opportunity to invest in their teams who are going to be critical as the organization grows over time,” Little said.

Markisan Naso

Markisan is an award-winning author, editor and podcaster based in Chicago. He’s the writer of the comic book series, BY THE HORNS and VORACIOUS, and has written hundreds of features covering subjects as diverse as EF5 tornadoes, infection control and real estate planning. He talks heavy metal every month as a host on the Metalheads Podcast.

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