Business Spotlight: 'The Gospel of Hospice'

Omega Health Care of Southwest Missouri Inc., one of the younger hospice providers in Springfield, strictly operates on four business pillars.

“We figure if we offer the best care in the industry and make the employee environment the best in the business, we will be respected within the community and that will result in us growing faster,” says Phillip Hill, co-owner and chief administrator of Omega Health Care’s Springfield branch.

The Lee’s Summit-based hospice provider entered the Springfield market in 2009 via an acquisition of Birmingham, Ala.-based SouthernCare.

At the time, Omega inherited four patients per day, and by the end of the year, the company had collected 18 patients. In 2010, Omega’s patient roster grew by 86 percent on its way to posting $1.34 million in revenues. This year, the number of patients served is up to 57 per day, and the company forecasts $2.5 million in revenues.

The growth in Springfield has spread to Joplin, where the company opened an office this month. The two offices serve patients in 21 southwest Missouri counties.

“We’ve stated goals that we just don’t come off of,” says Hill, whose company also operates in Georgia and runs three offices in Kansas under Sunflower Health Care Inc. “We’re also relentless in spreading the message and benefits of hospice care. We’re always on the grind, preaching the gospel of hospice.”

‘Heartrending venture’
Hospice itself is a young industry, with the first program opening in 1974, according to the National Hospice and Palliative Care Organization. The movement has increased nationwide each year since at least 2005 to roughly 5,000 hospice providers in 2009, according to NHPCO’s 2010 Hospice Care in America report.

The Medicare hospice benefit, which Congress enacted in 1982, is the major payment source for hospice care, covering 83 percent of hospice patients in 2009, NHPCO’s report found.

Naturally, Hill is a believer in hospice care, which positions a family member as the primary caregiver for a patient facing a life-limiting illness with hospice staff making regular visits and medical assessments.

“Hospice is the only government-run health care program that has been successful in improving patient outcomes and lowering costs,” says Hill, whose company only collects 1.5 percent of its business from private pay patients. “It’s a simple message but surprisingly people don’t know it. We’re constantly fighting the stigma of ‘government-run entity.’”

Omega officials also fight through the confusion between home health care and hospice care.

“Home health care is for rehabbing patients back to where they were before the episode,” says Omega Marketing Director Tasha Blackwell Ganson. “Hospice is palliative care with the goal of enhancing quality of life for the patient while maintaining dignity.”

While both are funded by the federal Centers for Medicare & Medicaid Services, the main difference is the terminal diagnosis required of hospice patients and the homebound status required of home health care patients. Those lines are blurring, Ganson says, now that hospice companies can take care of chronic patients.

Hospice staff often acts as a “tour guide” through hard times, says Hill.

“Hospice care is a worthwhile, heartrending venture in life,” says Sandra Owens, Omega’s volunteer coordinator, who previously worked for St. John’s HospiceCare, along with Omega Clinical Director Cindy Cody.

Omega’s Springfield staff comprises 22, including eight nurses in the field. The team celebrates small victories.

“If there is something a patient needs and it’s not in the supply room, we search the books, find it and get them what they want,” Cody says, pointing to a recent patient who was holding on to see a family member’s wedding but ultimately wasn’t well enough to attend. Omega caregivers set up a Skype service allowing the patient to watch the wedding live on a computer.

“That’s the gospel of hospice,” Hill says.

Labor ready
Providing hospice care hasn’t been without its challenges, in part, due to regulations.

In the last two years, the federal government has rolled out changes in the hospice system that have increased work loads without commensurate pay, Hill says.

On Jan. 1, 2010, CMS changes required hospice to start recording time spent in 15-minute intervals. For a service that doesn’t charge by time, Hill says the mandate has increased the amount of labor to start the care-giving process.

“It changed one bill from 212 lines to more than 13,000 lines,” he says.

Hill notes home care professionals already had been recording their time, and he thinks CMS is trying to study hospice and home health care side-by-side.

This year, the Patient Protection and Accountable Care Act required doctors or physicians to recertify patients’ eligibility to continue hospice care. After the initial 180 days, recertification must be handled in-person every 60 days.

“I have to schedule and pay a doctor or physician to fulfill that requirement,” Hill says. “They’re trying to dissuade long-term hospice stays.”

Medicare pays a set amount to hospice companies per patient per day, no matter the diagnosis or level of care given. Rates vary by county; in Greene County, the per diem rate is $137, according to Hill.

“Some hospices spend a lot of time in home and some spend very little, but they still get all of the $137,” Hill adds.

NHPCO estimates that 1.56 million patients received hospice services in 2009. And of the 2.45 million deaths recorded in the United States in 2009, 1.02 million people, or 42 percent, died while receiving hospice care.

“Some people still aren’t getting the message,” Hill says.

Omega has the staff and technology infrastructure to roughly double the number of patients served daily.

Almost 95 percent of Omega’s referrals come from physicians. With the growth of social media and online resources such as WebMD, Hill thinks it will soon be critical to connect to new demographics in new ways.

“The competition for mindshare at the physician level is so intense it’s hard to rely on physician referrals,” he says. “The trend of the world is to leave brick-and-mortar behind and move to dissemination of information straight to the people.”[[In-content Ad]]