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From Covid Recovery to Medicare Advantage-Ready: A Strategic Review for Hospice Providers

While the pandemic is still uniquely affecting the healthcare industry, providers must nevertheless keep one eye on the future and the long-term changes that will take place. For many sectors including hospice care, the next several years will be impacted in no small measure by Medicare Advantage health plans, which were officially introduced to the market on Jan. 1. 

In a previous webinar hosted by Forcura, industry expert Beth Prince, VP of Revenue Management at Corridor, discussed what hospice providers will need to do now and over the next few years to prepare for a boom in Medicare Advantage patients. 

First, Beth said hospice providers should be aware of the prevailing trends as they emerge from a pivotal period.  

  • There will be more demand for care at home and for post-acute services in general.  
  • Hospitals are diverting patients away from traditional acute care recovery settings and referring them directly to home-based care. 
  • Coding accuracy will become even more important as surveyors narrow their descriptions of inclusive services and expenses. 

Hospice providers will want to closely evaluate their finances and operations to gain a clear picture of where they are starting in the post-Covid era. Questions to consider: 

  • What percentage of revenue is coming from what source (fundraising, payer plans, community programs, etc.)?  
  • What is each person on the team doing and why? What are their expenses? What are they contributing to revenue generation? Is there anything they can do to essentially add a level of efficiency or effectiveness?  
  • What is the agency’s staffing model, and should adjustments be made to allocate resources optimally? How can the business better achieve goals, both from patient care and a revenue standpoint? 

To prepare for the anticipated growth of Medicare Advantage plans, this is what hospice providers should consider: 

  • Medicare Advantage participants are expected to capture as much as 48% of the national market by 2028, with some densely populated regions and areas with large senior populations already reaching high percentages.   
  • Patients will be required to follow progressive steps toward hospice care, so providers who build in various pathway services such as counseling and palliative care will obtain more referrals and Medicare Advantage contracts. 
  • To receive their patients, Medicare Advantage insurers will require hospice providers to demonstrate capacity, staffing, variety of services, and data-backed quality.  

Finally, hospice providers disrupted by Covid will need to equip themselves to the Medicare Advantage surge. 

  • A recommended best practice is to invest in partnerships, particularly where technology is concerned. The right tech partner will produce a high ROI, enabling agencies to function at optimum efficiency, reduce expenses and provide better patient care in a very short time.  
  • Providers will want to modify their workflow, their internal training and their expectations of staff to ensure they are meeting best practice methodology. 

As Beth Prince notes, it is not a question of whether or not great changes are coming to the hospice care sector, but when. Factors like Medicare Advantage will forever alter the current landscape, and those who prepare and become early adopters will position themselves for the most success.  

To hear more from our expert about how your hospice agency can prepare for Medicare Advantage expansion, access the webinar and enjoy the discussion. 

Watch the Webinar

Want more practical tips for optimizing your business operations and patient care? Read these blogs:

Read "Supercharge Your Cash Flow"

Read "Use HIPAA-compliant Mobile Scanning"

 

Robert Circle Picture

 

Robert is a Senior Content Writer at Forcura with extensive knowledge of the healthcare industry. He develops thoughtful and provocative information for administrators and caregivers in the post-acute market.

Connect with Robert on Linkedin

 

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