Trust and collaborative communication are essential to hospice executive teams seeking to weather a changing health care system.

This is according to HopeHealth President and CEO Diana Franchitto and the company’s CMO Dr. Edward Martin. Franchitto and Martin have led the organization for roughly 15 years. The nonprofit health system provides home care, hospice, palliative and dementia care across Rhode Island and southeastern Massachusetts. 

Regular communication is needed to build a strong dyad among c-suite executives, Franchitto said during a recent Husch Blackwell podcast. Daily conversations around the regulatory, operational and strategic trends occuring in the hospice space are a core part of sustainability in today’s health care climate, she stated.

“Things happen so quickly and it’s important that we’re in lockstep with one another, particularly with the regulatory environment,” Franchitto said. “We have more deliberate time talking, whether it’s about provider staffing [or] a certain strategic initiative. It’s so important, given the role of the CMO. These daily check-ins are critical.”

Hospices have come under increasing regulatory oversight during a time of prolific workforce shortages, rising demand and technology innovations that are reshaping end-of-life care delivery.

Having an engaged team in the c-suite that is capable of having open and honest discussions about these challenges is key to making informed business decisions, according to Franchitto.

The relationship between business and clinical executives is an important part of navigating ways to improve and expand clinical capacity – including conversations about strategic growth, technology and staffing investments, and compliance risks, she added.

“Health care systems are under inordinate financial pressures,” Franchitto said. “It’s really helpful to have a trusted CMO that has inordinate judgment that I can collaborate with, particularly as we talk with our board of directors about a new initiative or new strategic investment. He brings that clinical perspective that’s really helpful.”

Collaborative c-suite communication has been critical to HopeHealth’s workforce development and strategic growth outlook, Franchitto added.

The role of clinical executives has morphed to include more business-related decisions alongside those regarding patient care delivery, Martin said.

“Things have certainly changed,” Martin said. “Historically in hospice at times the medical director and physician role has been [less] active and involved. If we have an initiative that needs to happen, Diana will make sure it happens and that’s who needs to be at the table.”

HopeHealth partners with the LifeSpan Health System’s Cancer Institute and Accountable Care Organization (ACO), as well as several hospitals in its service region.

Recent strategic growth decisions have included the health system’s expanded pediatric hospice and supportive care service lines. HopeHealth in 2021 began providing inpatient and community-based pediatric palliative and hospice care to infants, children and young adults.

The health system is also a hospice and palliative medicine teaching affiliate for The Warren Alpert Medical School of Brown University.

C-suite and clinical collaboration has been a significant part of HopeHealth’s educational and service growth initiatives, Martin stated.

Case in point, clinical leaders brought up rising costs and length of stay concerns as key points when the health system decided to expand palliative care consultation services across its emergency department, he said.

This is one example of how having clinical insight at the decision-making levels can turn headwinds into tailwinds, Martin stated.

“It was a great investment for them to support our physician down in the emergency department,” Martin said. “It prevented 200 admissions since then and saved a couple million dollars. We’ve had great support from HopeHealth and Diana in terms of launching these initiatives.”