This article is sponsored by Enclara Pharmacia. In this Voices interview, Hospice News sits down with Deanna Douglass, PharmD, SVP, Business Development, Enclara Pharmacia, to learn about the parallels between hospice and the Program of All-Inclusive Care for the Elderly, or PACE. She also explains how Enclara is supporting the provision of PACE services and breaks down the areas of the Enclara value proposition that particularly resonate when it comes to that mission.
Hospice News: We have talked previously about your extensive experience in hospice pharmacy. With that perspective, what excites you about this field today?
Deanna Douglass: We continue to see consolidation in the hospice market, both in mergers and acquisitions and cooperative agreements among not-for-profits. There is also a trend toward diversification. There has long been a substantial overlap between home care and hospice, but we’re now seeing these providers looking into other areas of health care. Hospices are finally seeing more traction in terms of palliative care reimbursement. Several states now cover community-based palliative care in their Medicaid programs, and both payers and provider groups are seeing the value of these services in outcomes, customer satisfaction and overall medical spending.
Hospice has traditionally been siloed from the larger health care system in many ways. Would you say that is changing?
I do see a lot of potential for elements of the hospice model to influence other areas of health care. In many ways, hospice is the original value-based care. You have a per-diem payment under Medicare, and the hospice is responsible for nearly all the patient’s needs. Now, most of the health care system operates with some value-based components, but we have a long way to go in terms of both controlling costs and improving outcomes. Hospices may have some of the answers.
What are some of the areas of opportunity you see for hospice diversification?
There is a lot of interest in PACE, which serves high-need, high-cost patient populations with both acute health conditions and a need for long-term services and support. The PACE model has a lot in common with the hospice model. Like hospice, it started as a grass-roots movement in the 1970s, but unlike hospice, it never really took off in a big way. With the passage of the PACE Innovation Act in 2015, and the 2019 Final Rule from CMS, new PACE pilot programs are being approved in multiple states.
What aspects of hospice care align with the PACE model?
While the goals of care differ, there are commonalities, particularly the emphasis on patient-centered care. When you have one organization coordinating health care, home care, pharmacy and psychosocial needs, you see better outcomes. In hospice we treat the patient, not the disease. But what if we could do both? That is very much the idea behind PACE, and I think hospices have a strong foundation in terms of holistic, community-based services.
How do you see Enclara supporting the provision of PACE services?
Enclara excels across the whole spectrum of pharmacy services, including benefit administration, pharmacy fulfillment, business intelligence, clinical support and technology. We’re looking at where we can evolve these core competencies to meet the needs of the larger health care sector, including PACE. We will prioritize opportunities that align with our mission to improve quality of life for individuals experiencing progressive illness.
Are there areas of the Enclara value proposition that particularly resonate when it comes to that mission?
Although I have spent most of my career in business development, I am a pharmacist first. I gravitated toward hospice in part because it allowed me to make a difference in patients’ lives. As pharmacists, we have extensive knowledge of the safety, effectiveness and cost of medications. However, in many pharmacy roles, particularly in retail settings, that knowledge is underutilized. Hospices are more likely to engage pharmacists as members of their interdisciplinary team, and that has numerous benefits for patients. It’s even more powerful at the population level, where you can look at prescribing patterns and outliers, identify areas of opportunity, and really educate clinicians on best practices.
Finish this sentence: “In 2024, the hospice industry has been defined by…”
…exploring new opportunities while adhering to our longstanding values.
Editor’s note: This interview has been edited for length and clarity.
As the nation’s leading pharmacy services provider and PBM for the hospice and palliative care community, Enclara ensures timely and reliable medication access in any care setting through a comprehensive network of retail and institutional pharmacies, a national patient-direct dispensing program and dedicated inpatient services. To learn more, visit www.enclarapharmacia.com.
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].