Hospice Advisors Case Study
Title: General Inpatient Hospice Use
Company: A Hospice Company located in Georgia
Date: November 25, 2014
Problem: Delivering Value To The Hospital
Presenting Issues/Challenges: This hospice company was having a difficult time breaking into one of the community hospitals in its service area. The hospice had no clear cut strategy on how to go about approaching the hospital so as to deliver value.
We helped the hospice identify what some of the hospitals challenges were by using the AHD web site and by talking with one of the hospice’s medical director who had privileges at the hospital. We discovered that the hospital had major initiatives in place around the following:
- Lower Mortality rates.
- Decreasing inappropriate re-admissions.
- Maximizing its DRG Payments.
- Developing new sources of revenue.
The hospice did have a GIP Contract in place with the hospital but never used it. We went about developing a GIP Scatter Bed Program which had the following key elements as part of the program.
- The GIP Scatter Bed Program was built upon a contract between the Hospital and the Hospice that allowed the hospice to contract for beds and services. For every GIP patient that was admitted to a GIP bed, the hospice paid the hospital $400 per patient day expect for the day of discharge. The average anticipated Length Of Stay was 5 days.
- The hospice contracted with two physician (Hospitalists) from the hospital for services related to the care of the patients.
- A hospice nurse case manager visited the patient daily to both execute and adjust the hospice plan of care. This was done in collaboration with the nursing staff on the Unit where the patient is located.
- The hospice team (Nurse, Home Health Aide, Social Worker, Music Therapist, Spiritual Counselor, Volunteer and Physician) supplemented the care to the patient and also complete the discharge planning for the patient.
- The Hospice team worked with the Hospital to do educational in-services on the purpose of the GIP beds, the roles and responsibilities of the Hospital and the Hospice, and other related care issues. Special attention was given to the Emergency Department staff to discuss the use of GIP Scatter Beds for process to directly admit patients from the Emergency Department.
- The Hospice team worked with the Hospital’s medical staff to enhance their awareness on both the clinical and financial benefits to using hospice.
- As the GIP Program grows, the hospice provided a Clinical Nurse Liaison (s) assigned to the Hospital to assist with hospice dialogue and interaction with patients and families, to complete the GIP admission process, and to work directly with the Emergency Department staff. The Clinical Nurse Liaison was a supplemental resource and is an “adjunct” staff member that assists with the execution and patient care of GIP eligibility patients.
- The hospice worked with the Hospital to secure any needed contracts with insurance companies and/or provider groups to increase the ability to use the GIP Scatter Bed Program.
- Enhanced clinical outcomes
- Reduction of Mortality Rates and Average Length Of Stay
- Ability to directly admit patients from the Emergency Department, thus reducing inappropriate hospitalizations.
- Maximization of the DRG payment
- Incremental revenue from GIP payments