A focus on quality development can improve patient care in addition to a hospice’s bottom line as they prepare to show their value proposal to payers if the Medicare Advantage hospice carve-from comes in 2021. Providers may benefit from changing their organizational principles and shifting their work towards a pay-for-performance perspective in anticipation of their payment model changes.
“When we look at quality care provision, providing high-quality care and experience in a patient center model is a necessity and not just nice to have for today’s hospice provider,” stated Jennifer Kennedy, senior manager of regulatory and quality for the National Hospice and Palliative Care Organization (NHPCO) at a recent seminar. “When you look at health care and quality in the United States, we have the highest rates of avoidable mortality because people aren’t receiving timely, high-quality care. The government is really invested in making sure that the cost of care is within containment, but also that the quality of care isn’t lost when dollars are contained being spent on health care. The aim is to really improve overall care by making care more patient-centered.”
Hospice leaders are generating change from the inside out in expectation of their Medicare Advantage carve-in, slated to start Jan. 1, 2021. Despite proposed legislation seeking to postpone implementation of this value-established insurance plan (VBID) model demonstration project to begin at 2023, hospice providers are bracing for effect and strategizing sustainable best practices. Purchasing workforce and reevaluating personnel policies are plans in aligning with the forthcoming payment arrangement changes made to boost quality and expertise of individual care.
“We’re seeing payment models which are being developed in the [U.S. Centers for Medicare & Medicaid Services (CMS)] degree which are actually focusing on invention and also value-based buying,” explained Kennedy. “That is here to stay, and we’ll see moving forward. Workforce development is really an investment in people to prepare the next generation of health care professionals and support that lifelong learning for providers that they will need in order to provide high-quality care. Organizations have the opportunity to deliver quality care to their patients and their families by committing to developing a culture of continuous quality improvement and patient-centered care. Having a person-centered model is not enough. It needs to be adopted into that organizational culture.”
Focusing on reducing turnover and reducing employees shortages have been continuing struggles as hospice suppliers operate towards patient-centered care. Embracing a culture of quality may result in less worker turnover and frustration, more effective regulatory polls, better satisfaction scores and enhanced community reputations, according to Kennedy.
Strategies in changing towards constant quality may consist of worker self-assessment studies to determine areas of demand, in addition to continuing performance improvement tests with clear expectations from hospice leadership. Involving staff across different preferences in simplifying and implementing best practices for quality patient care advancement is just another strategy to promote labor cooperation and dedication.
“Currently, we are doing a pay-for-performance model for our staff and it’s creating a cultural shift,” Sarah McSpadden, president and CEO of The Elizabeth Hospice at California. “Takeaways from the shift in performance is to keep the standards objective to ensure that they’re accountable and measurable. Include all the stakeholders in the rewards determination. Talk about quality with everyone in the organization and celebrate it often. Celebrate the tick up in something you’re measuring. Celebrate all the changes you’re creating in better patient care outcomes for the people in your community, and then make success possible on an individual basis for accountable staff that uniformly follows standards and holding each other to them.”
Moving towards a pay-for-performance prognosis can reestablish a hospice to follow and implement improved standards of care for individuals and families. Plans may include both medical and non-medical regions of patient care, enacting methods to quantify experiences and feedback to enhance care delivery throughout an organization’s continuum.
“We are steadily moving in the direction to develop pay-for-performance, value-based payment models that really attached financial incentives and disincentives of providers as part of the national strategy,” stated Kennedy. “Developing a culture of quality is continuous. It’s not that you’ve reached this particular goal and now you can sit back and relax. You’re constantly self-assessing where you can make improvements in your organization. If you haven’t dedicated resources to a quality improvement culture and system, you’re really going to be successful in these payment models.”