1. A Lincoln Healthcare Leadership Event
Case Study: Ohio Hospice Inc.:
The Challenges and Rewards of
Building a Hospice Partnership
Kent Anderson, MHA/MBA
President/CEO,
Hospice of Dayton
Kerry Hamilton
President & CEO,
Hospice of Central Ohio
2. A Lincoln Healthcare Leadership Event
New Care Continuums for Success in a
Changing Health Care Landscape
Or ……
4. A Lincoln Healthcare Leadership Event
Bundled Payments for Care
Improvement (BPCI) Initiative
On January 31, 2013, the Centers for Medicare & Medicaid Services (CMS) announced the
health care organizations selected to participate in the Bundled Payments for Care
Improvement initiative, an innovative new payment model. Under the Bundled Payments for
Care Improvement initiative, organizations will enter into payment arrangements that include
financial and performance accountability for episodes of care.
5. A Lincoln Healthcare Leadership Event
WHY
“Great organizations change before they
have to change. Lucky organizations catch
up to change. The rest are history.”
Sinclair Community College President
6. Migrating to Total Cost Accountability
Charting the Path of Payment Reform
Source: Advisory Board interviews and analysis.
Continuum of Payment Models
Episodic Cost Accountability Total Cost Accountability
Partial
Capitation
Pay-for-
Performance
Bundled
Payments
Shared
Savings
Traditional
Fee-for-Service
Provider Risk
Full
Capitation
Minimal Substantial
7. A Lincoln Healthcare Leadership Event
WHY
•Assessing our Core Competencies
– Frail
– Elderly
– Chronically ill (terminal)
– In all settings
•Cost Effectively
– Low hospital utilization
– Less prognostic testing
– Less futile intervention
•Better Outcomes
– Lower symptom burden
– Prospective intervention
9. A Lincoln Healthcare Leadership Event
Health Care in America
•87% of older adults have at
least one chronic illness
•68% have two or more
•Higher than most developed
countries
10. The New Logic of Partnership
Intent of Mergers and Affiliations Rapidly Evolving
Source: Post-Acute Care Collaborative interviews and analysis.
Objectives of Partnership
“New
Market”
Partnership
Value
Scale Scope Reach
Geographi
c
ClinicalOperation
al
Financial
Consolidate
local position
Centralize supply
purchasing
Merge back
office
functions Increase
operationa
l efficiency
Integrate
services across
care continuum
Develop care
management
competencies
Stake regional
footprint
Establish
national
network
11. A Lincoln Healthcare Leadership Event
Only the strong survive
(remain relevant)
•Only the strong, innovative, high quality, low cost,
data integrated, value-based and value creating, data
rich hospices survive
•Regulatory burden will only increase
•Reimbursement will not keep pace with cost
pressures
13. A Lincoln Healthcare Leadership Event
Relevancy – That is the Question
Will you or won’t you be relevant in VBP?
CASE IN POINT…….
Disruption is Here
14. A Lincoln Healthcare Leadership Event
• Mortality rates among the fee-for-service Medicare population fell 16% from 1999
to 2013. Patients were 45% less likely to die during their stay; 24% less likely to die
within a month of admission; and 22% less likely to die within a year, the study in
the Journal of the American Medical Association (JAMA) reported.
• Lead cardiologist Harlan Krumholz, lead author of and a professor at the Yale
School of Medicine said that’s equal to more than 300,000 fewer deaths a year in
2013 than in 1999. The study was based on records from more than 68 million
patients in Medicare, the federal health insurance program for people age 65 and
older.
• Among fee-for-service patients, hospitalization rates fell 24%, with more than 3
million fewer hospitalizations in 2013 than 1999, Krumholz said. When patients
were admitted to the hospitals, they were 45% less likely to die during their stay;
24% less likely to die within a month of admission; and 22% less likely to die
within a year, the study found.
MORTALITY RATES DROPPING FOR
MEDICARE POPULATION
16. A Lincoln Healthcare Leadership Event
Ohio’s Hospice Value
Proposition
• Optimizing Care & Services – Outcomes and
Consistency (Highly Reliable Organization)
• Optimizing Resources – Strengthening Mission
• Optimizing Mission & Brand
• Scale to become a risk bearing organization
• Preeminent post-acute chronic illness provider
17. Not-for-Profit
Not-for-profit status and
20 or more years of
experience.
Hospice Certified
Hospice-certified nurses
and doctors on staff and
available 24 hours per day.
Palliative Care
Palliative-care consultants
who can begin care if
you’re not yet ready for
hospice.
Inpatient Unit
An inpatient unit, where
patients can go if
symptoms can’t be
managed at home.
Wherever You Call Home
Ability to provide care in
nursing homes and
assisted living residences.
Approved By Medicare
Medicare approval.
How to Choose a
Hospice Provider
18. A Lincoln Healthcare Leadership Event
Questions?
Kerry Hamilton Kent Anderson
President & CEO President & CEO
Hospice of Central Ohio Ohio’s Hospice
741.788.1403 937.781.1308
khamilton@hospiceofcentralohio.org kanderson@ohioshospice.org
