Hospice Advisors Case Study
Title: Building a Committed Medical Team
Company: A Hospice Company located in New Mexico
Date: December 11, 2014
Problem: Building a Committed Medical Team
Presenting Issues/Challenges: This 370 ADC hospice company had an historical issue of hiring and building a committed quality medical team. This hospice would solely hire physicians based on what they felt the physician could give them in terms of admissions. This was the under lying issue. The hospice did not have a clear medical development plan in place on how best to meet both the quality, service and growth goals of the organization.
Plan of Action: In working with the hospice leadership team we developed a medical staff development plan. The plan was focused on addressing quality, compliance and access issues. The team also felt that if it was legal, ethical and moral, the more physicians they could engage in a business relationship the better. The team also changed the criteria they used to hire a physician. They focused on: reputation and quality, hours to give to the hospice, practice location, type of physicians, how vast their network was in terms of introducing the hospice to potential referral sources and the ability to help the hospice grow.
The medical plan that was executed resulted in the following:
- A medical director that led Team Meetings and assisted in compliance to the requirements and specifications in the Conditions of Participation.
- Three Associate Medical Directors that assisted with Team Meetings, Face-to-Face requirements and geographic coverage.
- The hospice developed three General Inpatient Hospice (GIP) Scatter Bed programs at three different hospitals. At each hospital, we contracted with two physicians per hospital, they all were hospitalist, to do the GIP initial visit work- up and follow-up visits.
- We created a consulting/contractual relationship with a Cardiologist to help us develop a Palliative Care and Hospice Cardiology specialty program.
The Medical Staff Development Plan also called out the following activities to assist the organization work with and develop their physicians:
- The Executive Director held three dinner meetings per year with the physicians listed above. The agenda for the dinner meeting included a review of Key Performance Indicators, challenges and opportunities facing the organization and new strategies. Each physician gave a brief overview of their work and anything they wanted to share. These dinners helped create a bound between both the physicians themselves, as well as, the organization.
- We assigned a Community Liaison (marketing person) to each of these physicians and developed a relationship development plan that was executed on behalf of these physicians.
- We held an annual Medical Staff Education event. This was a day and a half education and social event. Held at a nice Hotel, the physicians and their wife/significant other were invited to attend. Starting on a Friday, several education sessions are provided. We secured a highly qualified Board Certified Hospice and Palliative Care physician to be the faculty for the meeting. On Friday night we held a nice dinner which facilitated an opportunity for socialization. Saturday was a half day education session.
- A strengthened compliance program around clinical issues.
- A more cohesive medical staff.
- A new Palliative Care and Hospice Cardiology Program
- Three new GIP Scatter Bed Programs that increase overall hospice admissions respectable from these three hospitals over a 3 months period: 6.4%, 8.1% and 11.9%
- The ADC for the program grew to 429 from 398