Quality, Culture Are Watchwords for Hospices in 2024

Amid intensified regulatory scrutiny, staffing headwinds and shifts towards value-based care, hospices need to ensure that they’ve made a strong commitment to quality and to foster a positive workplace culture, according to hospice leaders.

Though many hospices have seen staffing volumes improve, competition for clinicians remains high and has providers grappling for ways to gain an edge. Getting ahead of this curve will include having a supportive organizational culture – one that attracts and keeps a dedicated workforce, according to Andrew Molosky, CEO of Florida-based Chapters Health.

“Companies who show up for their employees and not the other way around have a much smaller staffing problem than anybody else. You’re operationally efficient. You have more money to pay them. Your turnover is less; you have to reinvest less frequently. You have better care outcomes,” Molosky said during the Hospice News 2024 Outlook Webinar. “There’s a very practical application to making your employee your number one priority.”


Watch (click here): Hospice News 2024 Outlook Webinar

The hospice (and larger health care) workforce has been dwindling even as demand for care rises. Factors such as retirement and burnout are leading some clinicians to leave the field, and the limited number of health care workers with hospice and palliative care training have made the industry an employee’s market. 

A demonstrated commitment to improving the employee experience can go a long way toward helping hospices compete in the labor market. While compensation remains a crucial factor, salary and wages are not the end-all, be-all solution, Yolo Care’s CEO Craig Dresang told Hospice News during the webinar.


“Culture is everything. That is, at the local level, how we address staffing shortages. Beyond that, we’ve had to look at other creative ways to have incentive compensation for employees,” Dresang said. “Paying bonuses, in addition to competitive hourly salaries, company cars that are offered to clinical staff who do a lot of driving, covering 100% of their health insurance — all of that’s important. But at the end of the day, it really is about organizational culture.”

Hand-in-hand with culture is the quality of care. Now only is delivering quality services the right thing to do for patients, it will be a key to success when working within a value-based reimbursement environment, whether it be for hospice care or other services like palliative care or PACE.

Demonstrating both quality outcomes and reduced health care costs will be an important part of hospices’ competitive edge – regardless of a provider’s size, geographic reach or tax status.

Value-based players like Medicare Advantage plans and Accountable Care Organizations (ACOs) are connecting the dots between quality scores and care delivery costs. These entities are gauging how a hospice measures up in the U.S Centers for Medicare & Medicaid Services’ (CMS) star ratings in the agency’s Care Compare system, as well as results from Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys, and other key metrics, including reductions in hospitalizations.

Consequently, those are key data pieces for hospices when it comes to negotiating with payers or securing access to their networks.

“Quality will drive census. I believe that high quality equals sustainability. It’s going to be key in the future,” Dresang said. “It’s already important to have contracts with payers who are concerned about quality, but they want quality at the best price possible. So every year and this year, we are in a metamorphosis trying to get closer and closer to that mark.”

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