Community-based nonprofit hospices can help blaze a trail towards a better future in American health care. This will be a core philosophy underlying Blue Ridge Hospice’s strategic goals for years to come, according to the company’s recently appointed CEO Jason Parsons.
Virginia-base Blue Ridge services roughly 340 patients through its 2,200 square-mile service region, which extends across rural, urban and suburban communities. By year’s end, Parsons expects that census to grow to 400, in tandem with expansion in its hospice and palliative care services, as well as its new Program for All-Inclusive Care for the Elderly (PACE) initiative set to launch this year.
The organization has been on a growth trajectory during the past two years. In addition to its new service lines, Blue Ridge opened a de novo in Loudoun County, Virginia, last year and began exploring an affiliation with Montgomery Hospice & Prince George’s Hospice, also in its home state.
Hospice News spoke with Parsons about the ways community-based nonprofits can lead the way towards a better health care system, as well as his plans for Blue Ridge in 2024 and beyond.
What are your top priorities as you move into the CEO role?
Our first priority for 2024 includes the launch of our PACE program, which we call Blue Ridge Independence at Home. We believe very much in meeting the future by defining the needs and meeting the needs of the communities that we serve and in adjoining communities.
PACE is our first step in filling the gap between the onset of a chronic and serious illness and when people become hospice eligible. That gap is a fragmented, disjointed part of the health care system, dealing with chronic or serious illness or progressing serious illness. I think that’s akin to what hospices often hear, “We wish we would have called you sooner.”
I think that’s indicative of how fragmented and some cases chaotic and disjointed care is for people dealing with that. So PACE is part of our bigger strategy of filling that gap, PACE is our foremost priority. That program will be opening soon. As we develop that out, we think there’s enormous potential.
We’re just getting started in PACE, and then our second priority, we have expanded into all of Loudoun County, Virginia, which is one of the fastest growing counties in the United States. We think we have an enormous value proposition because of the high quality care that we provide. Loudoun County is very much a priority for us and other de novo opportunities that we’re looking at. We believe that we have opportunity in the adjoining areas to widen access to high quality care.
Our other priority is really just preparing for the future and our foundational excellence as an organization to leverage the fact that we are community born, not for profit hospices, and the unique and special way that those were developed by pioneers like our founder, Helen Ziebarth, who remains a member of our board of directors 43 years later. We can leverage that and leverage all the gifts and attributes of that and shoehorn it into really planning for the future.
We’re going to lay out a five-year strategic plan as a bridge between 2025 and 2030 that will define Blue Ridge Hospice’s role in the future. We know we will be along our strategic initiatives, which are to partner with others and to really bolster nonprofit hospices to develop a new care campus, which we’re working to do, and to participate in value-based care initiatives like PACE.
You’ve been in the process of securing a PACE license and building a facility. Do you have any updates on that hit? Do you have the license at this point? Where are you at with the construction?
The construction is complete, we have completed the construction, and we have about 18,000-square-feet. We completed that in December. We studied centers across the country and hired really great architects and thought leaders to help us really thoughtfully create a transformative place in terms of both the adult day center and the clinic.
We also have a pending earmark request from the federal government from [Sens. Mark Warner (D-Virginia) and Tim Kaine (D-Virginia)]. So if it passes, that federal appropriation will help us do even more in terms of the equipment and some of the lab and other services that we can provide not only to PACE participants, but also to Blue Ridge hospice.
We’ve just finished the site readiness review this week. We are nearing the final piece, which will be the signing of a three-way agreement between the Virginia Medicaid program, [the U.S. Centers for Medicare & Medicaid Services)] and Blue Ridge.
This is part of how we’re defining that continuum of care. It is going to be Blue Ridge Care, and so that’s the next iteration.
Regarding Blue Ridge Care, do you view that as a subsidiary? What’s the structure there?
We haven’t made a final decision on the full structure apparatus in terms of how they all relate to each other. But in essence, Blue Ridge Care will capture the work that we’re doing along that continuum — Blue Ridge Hospice, Blue Ridge Independence at Home, Blue Ridge Palliative Care Service. Of course, we have thrift stores that bring in $6.5 million dollars. All of that will constitute Blue Ridge care.
Blue Ridge Care is designed to define that continuum of care from the onset of a chronic or serious illness through hospice eligibility. We believe Blue Ridge Care’s role there is as a convener, an organization committed to high quality standards of care, to widening access for not just our community, but other communities in which legacy hospice providers have had a long history. So we really see a community-based transformation occurring.
You’ve mentioned de novos, do you have plans for further affiliations as here?
We don’t have any immediate plans. But I don’t want to presuppose anything, either. Our posture is very much looking for ways to get into the future, while running the strongest organization that we can. So we’re talking all the time to anybody that will come to the table.
We certainly plan to be talking and figuring out what we do as a nonprofit, legacy community-based care organization to be stronger together. That’s really the central organizing question. We’re very much committed to that and want to be leaders and conveners.
I know a theme that comes up in many of our conversations is that word, “future.” In the past you’ve said that providers “have to focus on solutions to the big questions that the American health care system and the hospice world grapple with. You should shape the future, not be afraid of it. Can you say more about how Blue Ridge is working to shape that future?
It’s the totality of how we’re oriented. I think so many organizations are afraid of the future, frankly, because change is challenging. But, ultimately, it’s a fool’s errand to only do what we’ve always done. The real endpoint for us is to be a care organization with hospice as a service line. We have to figure out a way to care for the total person and ascribe the total cost of care in an increasing value based arena.
Today one-third of our hospice patients are on Medicare Advantage.We’re very focused on what within Medicare Advantage and how we prepare for that. Part of it is the community-based transformation, and part of it is this convening around a broader nonprofit legacy based hospice transformation.
CMS is very interested in how we provide high-quality care more efficiently, and the chronic and seriously ill population are a major contributor to other high cost individuals, and they’re a major contributor to growing health costs. We have to grapple with how we not only exist, but thrive in that environment. And I think that hospices, if we lean into it, are uniquely positioned to grapple with that.
That’s why I PACE programs, for example, as at this stage of the evolution, and it’s going to keep evolving; I suspect for years. But at this stage of the evolution, with PACE emanating from a hospice program, we leverage the core of our competency in providing home-based care to complex individuals. We come equipped for success in that environment, and it helps us be part of that community-based transformation.
Not enough of our colleagues are leaning into some of these things. I believe that we have to lead the way and demonstrate that we are the leading edge of embracing some of these things.
We want to be a model for how smaller community-based hospices can really leverage and coalesce their energy and marshal their resources and their talent, to say, “We can be in the future business, too. This is not just for the big companies.”