This article is sponsored by MatrixCare. In this interview, Hospice News sits down with Tim Smokoff, General Manager, Home Health and Hospice, MatrixCare, to talk about the most pressing challenge facing providers in today’s hospice landscape — staffing. He discusses the key opportunities for navigating the current labor shortages and explains how outsourcing can help. He also delves into the advantages of working with a creative and capable technology partner to overcome staffing woes through collaboration.

Hospice News: What life and career experiences do you most draw from in your role today?

Tim Smokoff: I’ve spent more than 30 years in health IT and have seen almost every facet of this space, from the provider side and insurance to life sciences and public health These experiences have enabled me to work on a variety of projects in electronic health records and revenue cycle management so that I can approach opportunities in my role today with every aspect of the care journey in mind.

On a personal note, I’ve witnessed my own family members—parents, grandparents, and in-laws—navigate home health care, manage chronic illnesses and eventually transition through hospice care. My professional experience has given me the wherewithal to create comprehensive, user-oriented tools, but my personal journey with hospice care has added an entirely new dynamic to that perspective. It’s an aspect of life that many of us will, at some point, personally encounter, and staying in-tune with that enables us to be the best partner we can possibly be.

How is the evolving hospice landscape affecting recruitment and retention as agencies look ahead to 2024?

We’ve been out on a roadshow with customers, and staff turnover has been a recurring theme. On average, there is about a 25% attrition rate across our accounts, with some clients experiencing rates as high as 50% to 60%.

In a climate where clinicians frequently come and go, the importance of effective training, swift onboarding and high productivity cannot be overstated. Further, reducing and addressing errors during the learning phase is more important to maintaining quality service than it has ever been.

Turnover isn’t confined to clinical roles either, as back-office positions are seeing a significant amount of change as well. Supporting these businesses with real-time insights while managing error rates, particularly in claim submissions, is vital. Minimizing the back-and-forth of claims and optimizing billable services and visit schedules boost profitability. Higher profitability, in turn, enables higher staff pay, which can lead to better retention rates.

What are the top staffing challenges faced by providers in today’s hospice environment, and how is MatrixCare helping to address them?

This observation ties directly back to the importance of training. An interesting pattern we’ve noticed is that over 60% of our support line calls require no action—they’re purely training-related inquiries on system use. This highlights the short tenure of staff in hospice organizations and the high turnover rates. Our focus is on transforming this experience to be more passive and voice driven. By utilizing machine learning and advanced language models, we’re better equipped to convert spoken words into discrete data, populating forms that clinicians would traditionally have to fill out manually, thus streamlining their workflow.

Another key aspect is care coordination and collaboration. Given that staff work in teams, it’s critical to share information and collaborate effectively. Whether it’s clarifying steps, asking questions or sending updates, the ability to communicate across the care team is a fundamental feature of the solutions we’re committed to providing.

How can hospice providers better prepare to navigate labor shortages in 2024 and beyond?

When considering the operational aspects of hospice care, we often divide our focus between the front office and the back office. In the latter, our services extend to about 800 clients. This involves handling tasks like billing, coding, collections, OASIS reviews and CAHPS surveys. Especially for organizations experiencing staff shortages, we offer substantial support in revenue cycle management, which helps increase cash flow, reduce write-offs, and lower the rate of claim rejections. This, in turn, contributes to the virtuous cycle of being able to offer better compensation, attracting the right staff and improving retention rates.

Additionally, we offer a program called Training and Assurance Program (TAP). Through TAP, customers can purchase hours of expert consultation to evaluate their operations, spanning clinical to back-office processes. Our industry experts analyze how systems are used, pinpointing best practices and identifying efficiency gains. The goal is to fine-tune our clients’ operations to achieve better outcomes, enhance staff efficiency on both ends, and ultimately minimize errors by aligning with best practices.

How can agencies leverage technology to overcome staffing challenges and improve care delivery?

I often describe our technological approach as encompassing the three Ps: passive, predictive and proactive. We’re honing technology to be increasingly passive. Take voice capture, for instance, where a natural conversation with a patient automatically extracts relevant data down to specific entries for forms. Similarly, passive technology applies to remote patient monitoring (RPM) and telehealth, aiming to effortlessly track a patient’s daily activities and movement levels at home.

Our ambition is to harness this passively collected data through learning models to become more predictive, alerting caregivers to patients whose trends indicate a potential decline, prompting timely intervention before adverse events occur. By proactively engaging patients based on these predictions, caregivers can prevent hospital readmissions and pursue better health outcomes within their care settings.

Another aspect we’re exploring is the concept of a co-pilot, designed not to replace clinicians, but to augment their efficiency and accuracy. Imagine an initial patient summary that aggregates complex information—scattered across multiple documents and databases—into a clear, categorized snapshot, identifying possible conflicts and areas for further review. This tool will condense hours of preparatory work into minutes, giving clinicians a head start on assessments for fall risks, behavioral health, rehospitalization, and more. This co-pilot approach works quietly alongside clinicians, offering insights that empower them to deliver superior care.

What are some of the key components providers should consider when choosing a staffing technology partner?

I think agencies should be looking for a technology partner that is well-versed in their sector — one that’s open to feedback and reliably responsive. Financial stability is key; you don’t want a transient vendor but rather a steadfast partner committed for the long haul. It’s important to strike a harmonious balance between innovation and execution. Some organizations may prioritize innovation, yet lack in execution, while others might excel in execution but fall short on innovation, potentially causing you to miss out on efficiencies. An ideal partner should adopt an open platform approach, fostering integration and collaboration.

At MatrixCare, we recognize that we cannot cater to every need, which is why we lean on an open platform, allowing partners to leverage our system’s data, enhancing and expanding our capabilities.

Finish this sentence: “In the hospice industry, 2024 will be the year of…”

…more of the same.

I believe 2024 will closely resemble 2023 in many ways. The potential of machine learning and artificial intelligence to enhance caregiver efficiency and foster improved outcomes is significant. However, these are investments with a long-term horizon, and the essence of health care still hinges on the expertise of quality clinicians providing top-notch care. Our role is to facilitate their work by efficiently managing information capture, allowing them to concentrate on patient care.

While we anticipate our systems to evolve incrementally, machine learning will increasingly identify where we can make gains in efficiency. Yet, I don’t foresee a dramatic shift in the landscape in 2024, or even 2025—progress in this realm is more evolutionary than revolutionary.

Editor’s note: This article has been edited for length and clarity.

MatrixCare provides an extensive range of software solutions and services purpose-built for out-of-hospital care settings. As the multiyear winner of the Best in KLAS award Home Health and Hospice EMR, MatrixCare is trusted by thousands of home-based care organizations to improve provider efficiencies and promote a better quality of life for the people they serve. To learn more about their impact, visit https://www.matrixcare.com/hospice-software/. 

The Voices Series is a sponsored content program featuring leading executives discussing trends, topics and more shaping their industry in a question-and-answer format. For more information on Voices, please contact [email protected].