Innovation within the Hospice Benefit: Diagnostic Specific Programming and Other Opportunities

1. Innovation within the Hospice Benefit: Diagnostic Specific Programming and Other Opportunities Robin Stawasz, LMSW Director of Provider Relations and Family Services CareFirst Corning, NY Hospital/Hospice Partnerships for Providing Inpatient Palliative Care

2. Why change and why now? • Call for change within the hospice industry • Changing healthcare environment • Affordable Care Act • Medicaid reform • Medicare reform • Managed care • Heightened regulation • Staying ahead of the curve Hospital/Hospice Partnerships for Providing Inpatient Palliative Care

3. Why change and why now? • New opportunities to partner • Changing pressures on other providers • Creating needs hospice can meet • Become the solution to other people’s problems • Efficiencies inherent in shared service • Examples from CareFirst’s LifeBeat Cardiac Hospice Program Hospital/Hospice Partnerships for Providing Inpatient Palliative Care

4. Why change and why now? • New markets are available • Baby boomers increasing demand on healthcare • More informed • Higher level of sophistication • Drive for more home care • Increased provision of palliative care programs by hospices Hospital/Hospice Partnerships for Providing Inpatient Palliative Care

5. Why change and why now? • Survival • If we don’t do it, someone else will • Increased competition, even within certificate of need areas • Risk of marginalization, turning hospice into a “boutique” service Hospital/Hospice Partnerships for Providing Inpatient Palliative Care

6. Why change and why now? • Mission • Become true advocates for palliative care in all its forms • Traditional hospice is not the only way to meet our mission • Not just an option, growth is what we are called to do Hospital/Hospice Partnerships for Providing Inpatient Palliative Care

7. Change must be planned and purposeful • Based on need • Identify gaps within the care continuum • Perform empirical needs assessment • Meet needs of hospice • Meet needs of partner providers • Meet needs of families • Examples from CareFirst’s Breath Respiratory Hospice Program Hospital/Hospice Partnerships for Providing Inpatient Palliative Care

8. Change must be planned and purposeful • Create business plan • Perform comprehensive research • Examine models and similar programs • Share between hospices • Determine best practices • Outline how all stakeholder needs will be met Hospital/Hospice Partnerships for Providing Inpatient Palliative Care

9. Change must be planned and purposeful • Create a business plan • Define program structure • Assign all responsibilities • Propose a pilot program with expansion only when appropriate • Address liabilities • Include plan for staff development and marketing Hospital/Hospice Partnerships for Providing Inpatient Palliative Care

10. Change must be planned and purposeful • Create a business plan • Create a budget for both finances and time • Join into formal contracts whenever needed • Examples from CareFirst’s Inpatient Palliative Care Program’s Business Plan • CareFirst’s Grief Services Development Plan Hospital/Hospice Partnerships for Providing Inpatient Palliative Care

11. Change must be planned and purposeful • Build partnerships with fellow providers • Develop buy-in and investment of stakeholders • Identify mutual benefits and goals • Open opportunities for all involved • Hospices historically operate in silos • Examples from CareFirst’s Living with Dementia Hospice Program Hospital/Hospice Partnerships for Providing Inpatient Palliative Care

12. Change must be planned and purposeful • Foster external change in how hospice is perceived • Challenge preconceptions and assumptions • Change has to be real • Tremendous marketing opportunity • Specialized efforts for public and for providers • Opening markets can create strong external advocates • Examples from CareFirst’s Breath program Hospital/Hospice Partnerships for Providing Inpatient Palliative Care

13. Change must be planned and purposeful • Fostering internal change within hospice culture • Change within individual hospices • Many are defensive of status quo • Our greatest strengths can often be our biggest obstacles • Comes through investment in process, education, commitment to mission • Must be solid prior to full launch of new programs • Examples from CareFirst’s LifeBeat program Hospital/Hospice Partnerships for Providing Inpatient Palliative Care

14. Change must be planned and purposeful • Fostering internal change within hospice culture • Shift within the hospice industry • Consistent message and coordinated efforts will benefit all • Increase our influence on healthcare industry in general • Increase use of benchmarking and sharing of standard process outlines Hospital/Hospice Partnerships for Providing Inpatient Palliative Care

15. Opportunities for Change • Diagnostic specific programs • LifeBeat • Breath • Living with Dementia • Mental Health outreach • Renal programming • Neurological programming Hospital/Hospice Partnerships for Providing Inpatient Palliative Care

16. Opportunities for Change • Managed care alliances • TBI/NHTD Waiver Alliance • Medical Homes • Accountable Care Organizations • Innovation grants Hospital/Hospice Partnerships for Providing Inpatient Palliative Care

17. Opportunities for Change • Hospital partnerships • Inpatient hospice admissions • Inpatient Palliative Care programs • Disease management clinics • Boards and committees • Joint quality assurance and utilization review efforts Hospital/Hospice Partnerships for Providing Inpatient Palliative Care

18. Opportunities for Change • Pediatrics • Perinatal programs • Medicaid waiver providers • Medicaid changes • Pediatric provisions for concurrent treatment and 12 month prognosis • Coming change to adult prognosis standards? Hospital/Hospice Partnerships for Providing Inpatient Palliative Care

19. Opportunities for Change • Marketing • Outreach campaigns • Example of CareFirst Re-branding efforts • Other ideas? Hospital/Hospice Partnerships for Providing Inpatient Palliative Care

20. Conclusions • Program development within the hospice benefit is replicable, beneficial and critical • True growth can only come through partnerships that benefit all stakeholders • Internal and external change must be planned and purposeful and can lead to new growth opportunities Hospital/Hospice Partnerships for Providing Inpatient Palliative Care

21. Questions? We encourage your questions and comments Hospital/Hospice Partnerships for Providing Inpatient Palliative Care

22. Contact Us • CareFirst • 11751 East Corning Road, Corning NY 14830 • 607.962.3100 or 800.734.1570 • www.CareFirstNY.org • Robin Stawasz, LMSW • Director of Provider Relations and Family Services • StawaszR@CareFirstNY.org • 607.962.4100, ext. 152 Hospital/Hospice Partnerships for Providing Inpatient Palliative Care