Hospice will continue to be in a state of flux this year and next, with a heavy focus on regulation and supporting and growing the workforce, according to Ben Marcantonio, COO and interim CEO for the National Hospice and Palliative Care Organization (NHPCO).
The coming year may also be a time of significant change for NHPCO itself, as the organization explores a potential combination with the National Association for Home Health & Hospice (NAHC), as well as further collaboration with other major stakeholders in the space.
Hospice News sat down with Marcantonio at NHPCO’s Annual Leadership Conference in Little Rock, Arkansas, to discuss the hospice industry’s priorities for the remainder of 2023 and into 2024.
Of course, program integrity is a critical issue for many in the provider community. But of course other priorities exist. What else is top of mind for you as you’re looking ahead to 2024?
Looking to head to 2024, a big thing will be how we continue to meet these strategic goals we have around collaboration, specifically with NAHC, but also with others.
I think the evolution that will be taking place and the impact that will have for not only us as an association, but for the field, is how we come together. Whether that manifests in a fulfilled affiliation, which is what we’re discussing with NAHC, or more intensive ways that we work together with projects and initiatives — that’s going to make a big difference.
We’re really attending to what’s happening in health care overall, and how that’s manifesting in hospice and home care and that whole continuum of care that is delivered in the home and in the community.
It’s our responsibility to make a difference in that way and to help shape what that is and becomes. I think that 2024 is going to be a very pivotal year for us, as NHPCO in our work with NAHC and in collaboration with other national groups and associations and with our members.
What do you think that will change in the coming year, as you look ahead to 2024 for hospice providers?
I think some of the biggest change is going to be related to workforce and adapting models for how they support, engage and retain their team members.
It’s of utmost concern and attention to leaders of our member organizations. They care deeply about their team members. They care deeply about the impact that staffing challenges have on them and on the patients and families who need them. Continuing to evolve again and adapt to and change to support those needs is going to be paramount.
The other is the amount of attention to the regulatory environment, but the areas of concern and the ways in which they’re going to have to pivot and address new regulatory challenges like the Special Focus Program, and what that would mean for anybody who might end up in that.
We’re working very hard to make sure that program is defined well, so that we identify the right programs who need to have a closer look, but also have it truly be what they say they want it to be — supporting them to help them be successful and achieve better quality.
We’re also working to make sure the algorithms are defined right, so that the right people, the right programs, get that help.
For all providers, the environment in which they operate will continue to be affected by that whole process.
What are you seeing at the state level in regards to program integrity and their response to these issues?
Right now, given that 17 of the 34 recommendations we and the other associations made are being implemented, I believe that what’s happening at the state level is that they see we actually have achieved some intervention.
They’re trying to really be attentive to what’s happening, so that anyone who is behaving in those ways with fraud and abuse are addressed. They want to help continue to support that process, so that they can grow into really strong providers in the state and so that access can continue to remain open.
We need to make sure that what we’re doing does contain the problem, continues to address the problem, and then diminishes and hopefully even eradicates the problem.
As far as you know to date, is this problem still contained to those four states (California, Nevada, Texas and Arizona)?
I think what we’re seeing in Arizona and Nevada and Texas was sort of a seepage. Once California put in the moratorium, [fraudulent hospices] began to look to where else they could go to engage in this behavior.
With the stop and the stop points that [the U.S. Centers for Medicare & Medicaid Services] has put in place, and the regulatory oversight, I think it’s arrested the growth of it. But we’re not going to just take that for granted.
There’s a vigilance to watch for red flags and make sure that it doesn’t come up elsewhere. But as of yet, we don’t see indications of that.