Hospice Industry Data from NHPCO - A Look Back Five Years

As Dr. Christian Sinclair pointed out in a recent post on the  blog Pallimed, the 2010 edition of the NHPCO report  Facts and Figures:  Hospice Care in America was short of surprises when compared to data from last year's report.

So I looked back to a 2005 report to better understand how the hospice industry has changed (or not) over the past five years. Among my surprises were these:

-Impressive growth in the percentage of decedents receiving hospice care. Sure, I expected growth, but not at the rate we've seen.

-Short-stay patients (7 days or less) remained level at one-third of total deaths and discharges. Is this an intractable issue, in which case hospices should consider improving their capacity to provide exemplary care for short-stay patients, or does there remain optimism that  knowledge of more timely (earlier) referrals will spread quickly, thus reducing the percentage of short-stay patients.

-The size of hospices remained small - nearly 8 out of 10 have fewer than three admissions per week. Given the speculative talk about consolidation, I  expected that over the past five years there would have been considerably fewer hospices admitting less that 150 patients per year.

Got me to thinking. If I was considering hospice care for a family member, aware that there is a one-in-three chance that the episode of hospice care will be no longer than a week, I'd want to select a hospice that admits ten times the number of patients than the average-sized hospice. I figure that the additional volume would mean greater proficiency in short-stay care.

Does volume matter? No studies to prove either way.
What do your professional instincts tell you?

Do Hospices Need Medical Staff Planning?

Hospices are evolving into advanced palliative care organizations (APCOs)in which care spans organizational and professional boundaries and physician services are integrated into a collaborative model that reconfigures a traditional nurse-centric organization,. Such a convergence will, unsurprisingly, strain an organization’s resources and its roles. For organizational strategic considerations, meeting community needs, and regulatory compliance, medical staff planning improves the likelihood of hospice success.

However, shortages of experienced, fellowship-trained, and Board certified Hospice and Palliative medicine (HPM) physicians and the growing need for such physicians in specific practice areas (long-term care, hospital consultative, home visit) will lead to increased frustrations among hospice executives, clinical staff, and physicians and hinder the achievement of hospices’ strategic goals.

Given the “not if, but when” trends surrounding the role of HPM physicians in a community’s end-of-life care practices, hospices that initiate a medical staff planning process in the short term will provide themselves with the time required to muster and develop the necessary financial and other resources to align their medical staff plan with their strategic objectives. Such a medical staff resource planning service will also help identify potential opportunities to enhance market position through physician recruitment.