Pallitus Health Partners is forging its own identity apart from its parent organization, Hosparus Health.

Based in Louisville, Ky., Pallitus provides palliative care to anyone facing serious illnesses such as cancer, heart failure, COPD and more. It also offers a support system for patients’ families, caregivers and other loved ones.

Although Pallitus is part of the Hosparus Health family, it has been establishing itself as an individual entity since 2021. With a service area that includes 41 counties throughout Kentucky and Southern Indiana, Pallitus is focused on helping people live better and longer with quality palliative care programs.

Dr. Dustin Dillon, medical director of palliative care services at Pallitus, said it was important for the palliative care provider to stand on its own. That meant helping community colleagues understand that Pallitus serves patients with any serious or life-limiting illness, regardless of their prognosis.

“Hosparus sounds a lot like hospice, and so many of our community colleagues were not referring patients,” Dillon told Palliative Care News. “So, we thought it was really important to make sure we differentiated ourselves from the Hospice business line.”

Powering up the program

As a separate entity, Pallitus offers patients a wide scope of services. Its community-based palliative care program is mainly geared toward adults who have some sort of advanced or serious illness. The majority of these patients are greater than the age of 65 with multiple medical conditions.

Dillon said the goal of palliative care support is to provide an extra layer to make sure they’re enhancing quality of life for their patients.

“We do that through expert symptom management,” Dillon said. “We are also always focused on making sure patients and families understand where they are in their disease process. If they don’t understand where they are and what to expect, they can’t really make decisions that make the most sense for them.”

Pallitus also has a robust pediatric palliative care program.

“We see patients in the prenatal period before a child is even born if they have a life limiting illness. So, we’ll meet those parents and help come up with a birth plan, and we see them all the way through the rest of their lives,” Dillon said.

The company has also invested in disease-specific programs, including those for cardiac patients and a second for those with pulmonary conditions.

These programs provide support to patients that may have heart failure or COPD through extra education and additional touch points with patients and families. Those programs also ensure that families have an emergency or crisis plan in place in homes, which allows them to intervene early if a patient’s chronic illness exacerbates.

“That helps keep patients out of the emergency room and out of the hospital because that’s really what our patients and families desire,” Dillon said. “So, we really do a lot of planning up front through the lung care program and heart connection program to prepare for a crisis mode.”

The organization also focuses on making sure advanced directives are completed for their patients. Dillon said it’s important for patients to put their wishes down on paper so that somebody else can make decisions for them if they can’t.

Breaking down barriers

Since January of this year, the average daily census for Pallitus has doubled, reaching 1,200 patients, up from 600 across the organization’s various palliative care programs. However, attracting people to its palliative care space isn’t always easy because of several obstacles in the community.

Dillon said roadblocks to patient care often include a lack of access to transportation, food scarcity and medical bills. To break down those walls, social workers at Pallitus have focused on assisting patients and their families before they even make it into the building.

Whether it’s creating a program to help get them to and from their medical appointments, partnering with local organizations to assist with food, or starting community clinics that are more easily accessible, Dillon said Pallitus endeavors to be a helpful part of the community.

“It was really, really important for us to remove any barriers for patients to receive community-based palliative care,” Dillon said. “That’s what patients and families want. They want to see medical teams that are a part of their community. They don’t want to go to a different part of town.”

One barrier breaker that Dillon is incredibly proud of is telehealth, a program that uses video-conferencing technology and data to improve the way Pallitus and Hosparus provide patient-centered care to patients and families.

It’s a technology Dillon admits he wasn’t initially on board with.

“Based on our patient demographics and how seriously ill they were, I didn’t know if telehealth was going to work,” Dillon said. “I laugh when I tell people I was absolutely wrong. Telehealth has been such a game changer, not just for us but for our patients and families. About a third of our visits are now done via telehealth.”

Telehealth allows Pallitus to assist patients quickly, which helps remove the potential barriers of distance and transportation issues. All patients need is access to a device with internet, a camera and a microphone, and a phone number to connect with a care team.

Achieving financial sustainability

Dillon said another big benefit of telehealth is that it helped Pallitus become more financially sustainable.

“In the community-based setting when you’re doing home visits and clinic visits in a fee-for-service world, it’s so challenging. We had to get innovative and think of how we can continue to serve patients and families, but also keep this program going,” Dillon said. “One of our big innovation goals was really to increase the amount of telehealth we were doing because it allows us to see more patients each day.”

Pallitus has also entered into some value-based arrangements with other payers and hospital systems to provide high quality palliative care more on a per-member-per-month fee schedule.

“That’s been very, very successful,” Dillon said. “We are trying to partner with payers, hospital systems and long-term care facilities to make sure that we are seeing as many patients and families as possible, but also remaining financially sustainable.”

From a billing standpoint, Dillon said Pallitus wants to make sure that they’re maximizing their billing and fee-for-service model. Two things that have enhanced their ability to be financially sustainable are the use of advanced care planning codes, and the development of principle care management codes.

“Principal care management is something that [the U.S. Centers for Medicare & Medicaid Services (CMS)] has really encouraged provider groups to do. This is reimbursement each month for all the work done by providers, physicians, nurse practitioners, RNs and social workers that’s typically non-billable time,” Dillon said. “It’s reimbursement for all of that time spent outside of a provider visit. That has very much helped us be financially sustainable.”

Dillon added that Pallitus is also seeing a shift from a fee-for-service world into a value-based world. To prepare for that, Pallitus is part of an accountable care organization called Responsive Care Solutions to better understand the value-based world.

Pallitus also has a longer standing value-based program through a local hospital and payer that provides a very successful per-member-per-month model.

“In the fee-for-service world, you want to maximize your reimbursement through good billing practices, and then also expand into the value-based world with partnerships with hospitals, long-term care agencies and payers,” Dillon said.

Delivering palliative care in 2024

Heading into 2024, Dillon said the focus for Pallitus is delivering high-quality palliative care, continuing to grow the program and serving as many patients and families as possible by removing barriers. 

“I think one of our big initiatives for 2024 is expanding services outside of the home in telehealth. We plan to embed providers in some local clinics; local sub-specialty clinics like oncology and heart failure,” Dillon said. “We want there to be an actual provider in those clinics to be able to see patients. We think that that is a model that is very successful.”

This goal to increase collaboration and coordination also extends to inpatient services. Dillon said Pallitus plans to focus on partnering with local community hospitals to provide inpatient palliative care support.

“We want to make sure that we’re having goals of care discussions and providing expert symptom management, and then really enhancing our partnerships with long-term care facilities to make sure patients and families get what they need,” Dillon said.