Healthcare leaders are increasingly looking at hospice and home health services as they seek to serve patients throughout the continuum of care. In February, San Diego-based Scripps Health entered the hospice market when it acquired Poway, Calif.-based Horizon Hospice. In March, 11-hospital, Denver-based SCL Health System partnered with home care management company Scottsdale, Ariz.-based Univita Health. Here, leaders at both organizations explain their strategy and the trend toward providing care in outpatient settings.
Filling a gap
For Scripps Health, the choice to move into the hospice market was sparked by the bankruptcy filing of San Diego Hospice, which later dissolved. As Scripps Health was San Diego Hospice's largest referral source, this closing created a gap in care for patients, according to Chris Van Gorder, president and CEO of Scripps Health. "As we were concerned about the potential total collapse of the hospice during bankruptcy and the fact that many of our patients' and former patients' care could be impacted, we made a decision to enter the hospice business," he says.
SCL Health's decision to create a home health joint venture was also motivated by a desire to extend services to patients beyond the inpatient environment. "Traditionally, SCLHS has been focused on providing high-quality acute care for patients while they are in our physical hospital walls. With our partnership with Univita, we are now able to extend that care into the home, working with physicians, nurses, patients and families to improve the overall care experience," says Rick Lopes, MD, senior vice president of health networks for SCL Health System.
Evidence of a growing trend
Moving into home health and hospice domains is one way healthcare organizations are becoming more integrated and coordinated to improve efficiency and quality and lower costs. "Healthcare delivery has been very fragmented over the years with multiple handoffs and companies delivering care," Mr. Van Gorder says. "It's well known that mistakes can occur during these handoffs and a patient can 'fall between the cracks.' Healthcare in the future must become more integrated, and healthcare providers like Scripps must either provide or collaborate more closely to provide the entire continuum of care."
Changing the hospital business
Reimbursement models like value-based purchasing, which rewards hospitals for meeting quality benchmarks, and initiatives like the Hospital Readmissions Reduction Program, which penalizes hospitals for preventable readmissions, are incentivizing healthcare leaders to look at care transitions more closely. "The depth and breadth of our program with Univita is aimed at reducing the length of hospitalizations, decreasing unnecessary hospital readmissions and improving the overall patient experience," Dr. Lopes says. "This is particularly important in the post-healthcare reform environment as we seek out better ways to address chronic diseases and illnesses, prevent complications and reduce costs."
In addition, a focus on population health and care management may lead to fewer hospital admissions, causing hospitals to look at other potential sources of revenue. These factors and others have resulted in a change in how hospitals operate as a business, and give a glimpse of a future healthcare delivery system in which the majority of services are provided in outpatient settings or the home. "Care within systems will become more regionally focused as opposed to campus-focused in addition to becoming more 'healthcare-focused' instead of 'hospital-focused,'" Mr. Van Gorder says.
"There has been a trend [of] care being delivered in less costly ambulatory sites and at home safely as technology and advances in care have made that possible for patients and providers. I believe that trend will continue and accelerate in the future as technology and care techniques continue to evolve, as patients and care sites become more integrated — connected via the electronic health record — and as wireless medical technology permits the monitoring of patients outside of the hospital and traditional care sites," he says.
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| Dr. Rick Lopes |
For Scripps Health, the choice to move into the hospice market was sparked by the bankruptcy filing of San Diego Hospice, which later dissolved. As Scripps Health was San Diego Hospice's largest referral source, this closing created a gap in care for patients, according to Chris Van Gorder, president and CEO of Scripps Health. "As we were concerned about the potential total collapse of the hospice during bankruptcy and the fact that many of our patients' and former patients' care could be impacted, we made a decision to enter the hospice business," he says.
SCL Health's decision to create a home health joint venture was also motivated by a desire to extend services to patients beyond the inpatient environment. "Traditionally, SCLHS has been focused on providing high-quality acute care for patients while they are in our physical hospital walls. With our partnership with Univita, we are now able to extend that care into the home, working with physicians, nurses, patients and families to improve the overall care experience," says Rick Lopes, MD, senior vice president of health networks for SCL Health System.
Evidence of a growing trend
Moving into home health and hospice domains is one way healthcare organizations are becoming more integrated and coordinated to improve efficiency and quality and lower costs. "Healthcare delivery has been very fragmented over the years with multiple handoffs and companies delivering care," Mr. Van Gorder says. "It's well known that mistakes can occur during these handoffs and a patient can 'fall between the cracks.' Healthcare in the future must become more integrated, and healthcare providers like Scripps must either provide or collaborate more closely to provide the entire continuum of care."
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| Chris Van Gorder |
Reimbursement models like value-based purchasing, which rewards hospitals for meeting quality benchmarks, and initiatives like the Hospital Readmissions Reduction Program, which penalizes hospitals for preventable readmissions, are incentivizing healthcare leaders to look at care transitions more closely. "The depth and breadth of our program with Univita is aimed at reducing the length of hospitalizations, decreasing unnecessary hospital readmissions and improving the overall patient experience," Dr. Lopes says. "This is particularly important in the post-healthcare reform environment as we seek out better ways to address chronic diseases and illnesses, prevent complications and reduce costs."
In addition, a focus on population health and care management may lead to fewer hospital admissions, causing hospitals to look at other potential sources of revenue. These factors and others have resulted in a change in how hospitals operate as a business, and give a glimpse of a future healthcare delivery system in which the majority of services are provided in outpatient settings or the home. "Care within systems will become more regionally focused as opposed to campus-focused in addition to becoming more 'healthcare-focused' instead of 'hospital-focused,'" Mr. Van Gorder says.
"There has been a trend [of] care being delivered in less costly ambulatory sites and at home safely as technology and advances in care have made that possible for patients and providers. I believe that trend will continue and accelerate in the future as technology and care techniques continue to evolve, as patients and care sites become more integrated — connected via the electronic health record — and as wireless medical technology permits the monitoring of patients outside of the hospital and traditional care sites," he says.
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