NCP Guidelines: Domain 1 - Structure and Processes of Care
December 8, 2018
2017: A Year of Transition
January 2, 2017
a: passage from one state, stage, subject, or place to another : change
b: a movement, development, or evolution from one form, stage, or style to another
Living in Washington, DC it's easy to think the entire country is focused on the upcoming inauguration. Since, despite what pundits might tell you -- we have no idea how the new administration's policies will impact hospice and palliative care providers, that's not what this blog is about.
I do believe the healthcare policy wonks who have said that value-based care is here to stay. However what that will look like is anything but clear. The only certainty is change.
For this annual new year's blog post, I pulled out my crystal ball, which told me that we'll see three prevalent types of transitions in 2017.
1: Many hospice and palliative care providers will continue the transition to value-based care. The Hospice Compare website will likely be published this spring or summer, providing an online portal that consumers can use to compare the quality scores of Medicare certified hospices. As a first step in this process, CMS published a directory of hospices as well as national averagesHospice Item Set (HIS) and the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Surveyin December of 2016.
Value-based care continues to provide opportunities for hospice and other providers to compete in the important post-acute care space. Hospices are starting to join other providers in building or acquiring new lines of business, including palliative care programs, home care agencies, and private duty companies.
While shared decision-making is beautifully aligned with palliative care, I'm not seeing providers embracing this framework as a means of differentiating services. Perhaps that will change in 2017...
3: Palliative care and hospice providers will hopefully continue to expand access to their services by providing culturally inclusive care. Programs operating in a crowded market must find ways to increase their market share and differentiate themselves from other providers. Given the trend towards a more racially-diverse Medicare population (according to MedPAC racial and ethnic minorities will account for more than one in four Medicare beneficiaries by 2030), programs that aren't focused on serving traditionally underserved populations do so at their peril.
Both NHPCO and AAHPM have created resources and articles to help providers increase cultural inclusion and access. A new book written by the kb group's Chief Research Officer, Kim Acquaviva, focuses on providing LGBTQ-Inclusive hospice and palliative care. The book includes tools and resources that can be modified to provide inclusive care to racial, ethnic, and religious minorities as well.
Other Important Transitions
The move toward more home-based primary care is gaining momentum within CMS. The CMMI demonstration project, Independence at Home, will "test the effectiveness of delivering comprehensive primary care services at home and if doing so improves care for Medicare beneficiaries with multiple chronic conditions." The model is reported to be very successful, saving Medicare millions of dollars in the second performance year.
The shortage of providers to care for the population in need of home-based palliative care provides opportunity for palliative care providers to partner with physician practices. Coupled with advance care planning and chronic care management, 2017 will likely see an increase in the number of physician practices offering or partnering with providers to offer clinic and home-based palliative care. Read more about home-based primary care in this article from the Remington Report.
There are other transitions happening to organizations, including the introduction of the kb group's new consultants and partners. I'm proud to announce that several former colleagues from NHPCO and Suncoast Hospice are joining the kb group to help clients have a successful 2017:
Gwynn Sullivan, Senior Programs and Strategy Consultant
Cozzie King, Senior Access and Diversity Consultant
Kathleen Taylor, Senior Communication and Training Consultant