Home-based care provider Compassus has been on a growth trajectory for several years running – placing hospice and home health at the center of its strategic vision.

Compassus provides home health, home infusion, palliative and hospice care across 30 states. The home-based provider also offers advanced care management and skilled nursing facility-at-home services.

Joint ventures with health systems have been an important part of expanding Compassus’ footprint and reaching patients in need of greater support in the home, said CEO Michael Asselta.

Hospice News recently sat down with Asselta to discuss the company’s growth plans after he stepped into his new role in May.

Photo courtesy of Compassus

Some of Compassus’ recent strategic decisions have included launching JVs with Ascension at Home, Bon Secours Mercy Health and more recently, OhioHealth at Home. What’s the significance of these partnerships as far as Compassus’ strategic plans and future goals?

For Compassus, a differentiator that is really important for our strategy is being aligned with a health system partner. As Compassus is growing in some markets thanks to health system footprints across the United States, we’re being assets with these joint ventures as we come together with the hospital programs.

We’ve been aligned with Ascension for a long time, and we’ve learned a lot. That started out as a home health and home infusion partnership and of course we serve them with hospice as well.

In our newer, more recent partnerships with Bons Secours Mercy Health and OhioHealth we also have home health and hospice. So, this is the core part of our strategy.

We think that our alignment with health systems gives us a different, and maybe a little more interesting, view of what the opportunity is with home care, both with hospice and palliative care, [and] home health and home infusion, all part of our strategies with these JVs. And there will be more, so this is indeed a strategy that Compassus is pressing into.

We [also] align closely with nonprofit faith-based organizations that share our mission, vision and values. It’s coming to the market with a really big validation that Compassus means what it says when we talk about our values, enough so that our community joint venture partners chose to work with us. Between the assets, the opportunity to address the community and validation of our mission … These are terrific starting points for any health care company that wants to compete in virtually any health care space.

Are there future plans for similar joint ventures, and will hospice or palliative care be a part of those strategic plans?

Thinking about legacy Compassus, we began as and have been a hospice company. So that’s actually the biggest part of our business. If you were to think about our business lines, hospice today is the largest. And it’ll probably be the largest in the future because our future joint ventures coming down the pipeline all involve hospice as well as home health.

Hospice will continue to be a large, if not the largest, piece of Compassus’ business, if you were to look at it by business line.

What are some of Compassus’ overall strategic growth plans in the near and long-term outlook? What are key pieces of achieving these goals? How does hospice and palliative care fit into this growth outlook?

We want to address the patient that needs care at home. In a broader sense, you have patients that would prefer to be at home [and] receive a number of services at home. So anything on that continuum is something that we would consider.

[We’re] thinking about this not purely from hospice, but thinking about the upline, palliative conversation that generally comes first. If you think about a patient’s journey, it’s often appropriate to introduce palliative care and hopefully the patient doesn’t progress to hospice, but at times the patient will.

So if you think about the health system relationship and us growing our palliative care business and being part of the patient journey even before hospice, then palliative and hospice are a really important fit. They go hand in glove. We’re very interested in that relationship between the palliative discussion and ultimately what may or may not become a hospice patient.

What do you see as the largest hurdles to sustainability and growth in the hospice space? What about on the palliative care side? What does Compassus see as the biggest keys to sustainable growth?

If you’re looking at the growth rate of the industry, or looking at demographics, you can kind of get one view of the potential for growth. The view that I think is important, and where I think we should focus is, on the utilization of home-based care.

The average patient is in hospice care for 20 or 30 days. Is that the right length of time? Do we need new patients to expand the market and grow our market? Or do we just need patients introduced to hospice at the appropriate time, which is nominally six months, not 20 days? There’s a built-in growth mechanism for home care and hospice, just by getting a patient into the services as appropriate for their condition.

We all know there’s more demand for home health than we’re able to address, and we can attribute that to nursing shortages and the fact that demand for home care is outstripping our capacity. I simply don’t see sustainable growth as a hurdle or concern. It’s there. We just have to find ways to address it.

Hospice is supporting and promoting those conversations with patients earlier. Whether it’s a palliative conversation or hospice conversation, it’s a difficult one for physicians and advanced practitioners to have. How as an industry do we support that conversation so that a patient gets the benefit of palliative and hospice much, much earlier?

If we can have those appropriate conversations sooner, there’s a lot more time in hospice, and that is good for the patient, good for their families and very, very good for the Medicare program, from a leverage standpoint and in terms of cost savings. It is the right thing to do.

So I’m not the least bit concerned about growth. I don’t see growth as a hurdle. I think it’s just us doing the right things to get our patients in the right care.

How do you see value-based reimbursement taking shape in hospice and palliative care payment?

I would call us to think about the specialty providers who are engaged already and accountable for certain populations in value-based care. These specialty physicians in some cases have already accepted some variation of global risk. If they’re responsible for global risk all the way through the end of life, palliative and hospice [providers] have an enormous role to play in delivering on value-based care, at least the cost part of the equation.

There’s qualitative value in hospice compared to ER visits and the disruptions that occur. We already buy into that, but especially for providers within the hospital who have their own private practices and who are also at risk globally, the end-of–life expense is extremely burdensome. They are absolutely looking for ways to serve the patient better and minimize those end-of-life costs that are unnecessary.

Sometimes it is a hospice conversation, but it’s easier to think about that in support services to wrap around a patient who is terminally ill. They need support to have those conversations to support their value-based commitments that invariably are tied to costs.