Establishing consistent relationships with referral sources will not only fill palliative care programs’ business pipelines, but it will also allow providers to develop better delivery models to meet the needs of their partners and patients.
As value-based models expand and hold health systems accountable for the entire care continuum, palliative care partnerships and joint ventures are growing in attractiveness. More health systems are beginning to see community-based palliative care as an opportunity to reduce overall health care costs while improvinh patient experiences and outcomes.
“In two years, I have seen it completely turn around,” Tiffany Hughes, COO of PalliCare, told Palliative Care News. “I think the industry as a whole, just health care in general, is recognizing palliative care and it is built into a lot of the metrics — cost-saving metrics. It’s almost a requirement for these large health systems. I think that home health and hospice always understood that palliative care was a way to fill the gap in their ecosystem, but these big physician groups, the hospital systems now are saying that they need it too.”
Providers must demonstrate value to prospective partners
Several key factors are driving more health systems toward palliative care, according to Nikki Davis, vice president of Palliative Care Programs for Contessa, a subsidiary of Amedisys (NASDAQ: AMED).
“The patient-centered approach aligns with a growing emphasis on patient experience and satisfaction in health care. Enhanced care coordination … supports improved patient outcomes, fewer duplicated services and reduced health care costs,” Davis told Palliative Care News in an email. “It addresses prevention of readmissions that are costly for health systems and can negatively impact patient well-being. Palliative care helps patients and families make informed decisions about their care and manage symptoms effectively.”
With health systems’ growing acknowledgement of community-based palliative care’s potential, providers must demonstrate the value of their services to capitalize on this movement and obtain full acceptance.
Palliative care providers must prove their worth by solving for what matters most to the referral source or prospective partner, Davis said.
“This includes improved outcomes such as high patient and family satisfaction scores, reduced hospital readmissions and enhanced quality of life for patients receiving palliative care,” Davis said. “Additionally, there is value in showcasing how palliative care can lead to cost savings by reducing unnecessary hospitalizations, emergency room visits and intensive, burdensome treatments.”
Negotiating with stakeholders
With the highly collaborative nature of palliative care, providers constantly work to build relationships with multiple stakeholders. Gathering and developing data points that matter to stakeholders can make the process much easier.
“It is important to consider the perspective and needs of hospital leadership, community partners (including referral physicians) and payers,” said Davis. “Adapting your negotiation strategy to their specific needs and priorities is crucial. If you can illustrate that your program has proven clinical benefits, complements other approaches to care delivery, improves care transitions, addresses patient satisfaction and provides cost savings, you can address any questions or challenges raised by individual stakeholders.”
Creating customized agreements based on the needs and priorities of their partners has worked well for both Contessa and PalliCare.
PalliCare’s customized agreements with large physician groups differ from regular referrals, Hughes shared.
“It is harder to do [customized agreements] than just get a referral from someone and do our own thing because we’re like in our own little silo,” Hughes said. “[With larger agreements], we’re working together constantly to change [and tweak] processes. … It is a lot of communication.”
Contessa customizes their agreements to best solve for what matters most to their partners. Addressing individualized reimbursement structures based on the needs of the health systems, for example, helped Contessa forge a good working agreement with a partner.
“It’s important to illustrate how palliative care can be customized to specific health system and patient goals, and how it interacts in a positive way with a health system’s overall care delivery ecosystem,” Davis said. “Palliative care teams add value when they collaborate with other specialties to offer comprehensive care and support other health care professionals in learning palliative care best practices.”
Standing out from competitors
Differentiation is always key in a competitive marketplace.
Having a customizable approach for each potential partner helps to tailor your strategy to match the unique needs and expectations of the market, according to Davis.
“For Contessa, this includes a diverse and skilled interdisciplinary team with the ability to adapt to different geographical needs/challenges, as well as culturally diverse patient populations. This includes flexibility in the modality of how services are delivered,” Davis said in the email. “Our technology, telehealth capabilities and innovation are also differentiators to help us enhance care coordination and streamline the care process to improve patient experiences.”
PalliCare has differentiated their company with the customized agreements and by working with a broad range of providers like hospice, home health, physician groups, nursing homes and health systems.
“We’re not funded by hospice. We’re not funded by a hospital system. So, we really can come in and blanket a community and meet all of their needs,” said Hughes. “We’re really kind of like the glue that holds all of that together for the patient before they get to hospice.”