Understanding the most prevalent medical conditions among aging patient populations is a significant part of developing disease-specific programs that better address physical, emotional and practical needs. A host of staffing, financial and logistical considerations are also part of the mix.
Community needs assessments play a large role in steering the direction of a disease-specific program, said Evan Dressel, director of strategy, program development and innovation at Lower Cape Fear LifeCare. Hospices need to take a wider lens beyond a patient’s primary life-limiting medical condition, he stated.
Examining patient referral and electronic medical records data can help hospices better understand the leading comorbidities across their service regions and focus on supporting different illness trajectories, Dressel said at the Hospice News ELEVATE conference in Florida.
“We ran a massive data set within our system to get us every diagnosis on every patient up to 25 fields deep to get as many diagnoses as we could,” Dressel told Hospice News at the conference. “We found a huge population of folks living with dementia that would not have otherwise surfaced if we were only looking in the primary diagnosis field, which is often how reporting is set up. It’s something I encourage folks to think about if you can get into any data, any diagnosis field beyond the primary.”
Lower Cape Fear LifeCare provides hospice and palliative care in North and South Carolina. The nonprofit has a dementia program, LifeCare Memory Partners, and is a participant in the Guiding an Improved Dementia Experience (GUIDE) payment model demonstration. The hospice also provides home health, bereavement, advance care planning and veterans services.
The hospice and palliative care provider is also launching two new disease-specific programs that will focus on serving patients with cancer and congestive heart failure (CHF). These were two diagnoses found among a large volume of patients, Dressel indicated.
Having a deep understanding of patient data can help hospices better grasp the outlook of a new program’s average daily census volumes, clinical capacity and operational needs, Dressel stated.
“We have a very high cancer incidence in our region, yet really few cancer support resources,” he said. “We are going to build out a cancer-specific program that is going to be really oriented in the vein [of] supporting our local oncologists and delivering more of a network of support services. Then we have a CHF clinic that we’ve started because we have a high population of [these] folks.”
Navigating service needs, strategic execution and establishing successful care collaborations are crucial components to consider when building a disease-specific program, according to Kelly Gadison, vice president of clinical practice, strategy and programs at Amedisys.
Amedisys is among the largest home health, hospice and palliative care providers nationwide and serves roughly 465,000 patients annually across 38 states. The company also offers high acuity services such as skilled nursing and hospital-level care at home. Amedisys’ disease-specific services include programs for patients with dementia and end-stage heart failure. The company last month was acquired by UnitedHealth Group (NYSE: UNH).
“What we’re really looking for is to be able to differentiate the level of care,” Gadison told Hospice News during ELEVATE. “It’s about serving our patients, but then the caregiver burden and also serving our clinicians [and] our referral sources. It took a lot of time to think about the service aspect in all the different facets that we need to address. [It’s also] the strategy, so how are we going to meet the needs of the patient while meeting the needs of caregivers? Those don’t always equate the same. If we’re going to put something in place, it’s got to be able to meet everyone’s needs for that area.”
Launching a new disease-specific program can allow for more diverse training opportunities, according to Gadison. This can help strengthen recruitment and retention rates by putting more career paths in place while expanding clinical expertise and excellence, she said.
Delivering a wider breadth of high-quality care can drive a hospice’s referral reputation and growth potential, Gadison indicated. Having a diversified service repertoire can allow for greater continuity of care and better care transitions, while also helping patients remain in the home, she added.
“It’s continuously evolving … for both patients and families who no longer really wanted curative care but don’t know how to deal with symptoms in the moment, and clinicians who needed that upskilling to a different level of expertise,” Gadison said. “We saw that from a perspective of needing really timely care, from someone calling for [durable medical equipment (DME), versus someone calling with a need of struggling to breathe. It’s how we needed to be able to elevate those patients, to keep them comfortable and in the home environment. That really drove the development of these programs in a holistic manner.”
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