Montana-based Headwaters Hospice and Palliative Care LLC will soon unveil a new palliative care service line, set to launch later this year. The move comes as the hospice provider expands its reach across its home state.
Headwaters serves a 30-mile, predominantly rural geographic service region across Helena, Montana. The locally- and veteran-owned hospice provider saw its first patient in 2023, and has met the challenges of rural hospice care delivery with both resilience and adaptability, according to Michael Brown, co-founder of Headwaters.
Patients in rural, mountainous regions face some of the most significant struggles in terms of accessing and receiving end-of-life care, Brown stated. Recognition around lagging clinical resources was among the forces propelling Headwaters to establish and grow its hospice program, seeing promise in a new palliative care service line in coming months, he added.
“We have kind of married our health care experience with the structure and accountability of our founders having a military background,” Brown told Palliative Care News. “There’s a lot of rural communities that are under-served because there aren’t many hospice providers here and it’s less productive to spend so much time on the road. We recognized that there was a need in this community and an opportunity for us to fill that gap. Right now we are providing hospice, but we are actively starting a palliative program.”
Headwaters has expanded its service offerings across two counties in Montana. The hospice provider recently opened an office in Butte, Montana, that serves as a hub for staff serving patients in surrounding communities. Seriously ill patients lack support in this particular region, according to Brown. Many are on a waitlist for the only palliative care provider currently serving the area, a local hospital, he stated.
The lack of resources can have significant impacts on vulnerable patient populations with unmet needs, Brown said. Headwaters recognized an opportunity to reduce disparities and drive quality through the development of a new palliative care program.
Among the goals of the program is to improve care coordination, continuity of care and timely access, according to Brown.
“We get referrals from different providers in the area, and we’ve figured out that if we can start building up that pool of palliative care patients, there’s more continuity of care if we combine that with hospice services,” he said. “It can be a grey line in terms of making sure patients are getting the right services for their level of care. Pairing these [hospice and palliative] services can help make that line more finite so that through communication and collaboration we can know when it’s time to transition them.”
The journey to launch a palliative care service line has come with several operational, staffing and financial considerations, Brown indicated.
Among the first steps has been identifying the best possible staff to provide palliative care, as well as finding creative ways to support these services, he indicated. Headwaters has pivoted some of its back office staff to assist with patient admission and other administrative processes until it is able to expand its interdisciplinary palliative workforce.
The hospice provider is currently seeking federal grants to help cover the cost of its new palliative care program and associated operating expenses, according to Brown. Cash flow is among the most significant challenges on its radar, he added.
“Unfortunately the reimbursements are low in this palliative care field, and so that just adds a layer of challenge because of the lack of funding,” Brown said. “There’s obstacle after obstacle, and you have to be creative, innovative, resilient and solutions-oriented. We want to make this a sustainable service we can offer. The need for hospice and palliative care services is only going to continue to grow in the next five plus years.”
Seeking out the insight from other providers with successful palliative care programs has also been a key strategy, Brown indicated. Headwaters has collaborated with a consultant on care delivery approaches, operating procedures and employee processes throughout the development process.
Recruitment and retention will be a significant driver of sustainability for the palliative care program, Brown said. Organizational culture and values play an important role in the ability to find and keep a pool of dedicated staff.
“A lot of organizations ‘talk the talk’ but not necessarily ‘walk that walk’ of their core values,” Brown said. “From top to bottom, our entire team makes all of our decisions based on core values, and our team appreciates that, which is why I think we have little to no turnover. I gave up trying to hire based on someone’s skills, because we can teach them how to do a job, but we can’t teach them how to care and align with our internal values.”