There was a big buzz in Phoenix last week at the NAHC Annual Meeting. Everyone was talking about Palliative Care. And some seeing it as the next great panacea!!

My thoughts. BE CAREFULL!!! From a business perspective, unless you truly understand your objectives as to why you want to add Palliative Care to your Hospice and Home Care mix, you may be leading your organization astray.

Don’t get me wrong, I believe Palliative Care is a wonderful things for patients and families!! Unless an organization truly understand the “why” to doing a palliative care program (and there are several different models!) the “how” may cause your organization to be on a palliative care regime itself!!

I wrote a post on October 10, 2014 on the Power of Strategic Thinking/Planning. I would encourage you to go back and read that post and apply some of that thinking to your organization’s process in exploring whether or not or how to jump on the palliative care “band-wagon”. What is your main objective? Is it to capture more patients who will require hospice in the future? Is it to create a new profitable service line? Is it to position yourself more broadly with payers and ACO type organizations? What is the fundamental reason for getting into palliative care?

To help answer this important strategic question it is important to have a feel for the different types of palliative care models/programs that are out there. For example:

A Palliative Care Consult Service. This approach is primarily a physician driven model where a health plan or physician group makes a referral to a Board Certified Hospice and Palliative Care Physician to do a consult. The consult is completed and recommendations and the patient are returned to the referring provider.
A Palliative Care Program: This is the full blown model of where a patient is referred to a Palliative Care Program and both a consult and treatment plan are developed and the palliative care team (Physicians, Nurses, Social Workers, Mid-Level Providers, and community partners like Home Health and Personal Care Companies) oversee the care of the patient. The primary business objective here is to keep the patient out of the hospital while delivering a superior service.
Inpatient Hospital Palliative: This is a cross between the first two models where a consult is given and treatment plan developed and executed. This is an inpatient focused program.

One of the things discussed in Phoenix was the profitability of Palliative Care Programs. Now wait a minute. Because of the fact that “when you have seen one palliative care program you have seen one palliative care program”. Most all the models are different which makes if extremely difficult to compare and contrast programs from a profitability stand point. Some programs measure themselves on a pure P&L bases, some give financial credit to the conversion of a palliative patient to a hospice patient. Other programs count part of their fund development or grant dollars into how the program performs. One thing I can say with certainty is that I have not found a palliative care program that stands financial sound on it owns and does not include any subsidies. I can say with 99.9% certainty that all hospital based palliative care programs are subsided!!

This does not mean a palliative care program cannot add value to your organization. It all depends on how you answer the “why” question as to what your very specific business objectives are.

To get a feel for what was presented at the Annual Conference, go to nahc.org. Then go to meetings – 2014 Annual Meeting; session handouts.

The Best!!