High-quality end-of-life care is a vital component of a well-functioning healthcare system. The combination of hospice care and end-of-life care affords patients the compassion and dignity they and their families deserve.
Correctly deployed hospice and end-of-life care also results in major reductions in unnecessary utilization and significantly decreases medical costs. However, many provider groups are unsure whether and how to launch such programs to provide the most benefit to patients, their families, and their providers.
Health Benefit Consultants, Share Your Expert Insights in Our Survey
Jacob Hochberg Jacob Hochberg is the Executive Director of Customer Insights at Arcadia, the leading population health management and health intelligence platform. Arcadia transforms data from disparate sources into targeted insights, putting them in the decision-making workflow to improve lives and outcomes.
Additionally, providers face challenges in identifying the right patients who would benefit from hospice care at the right time, targeting physicians for educational content about hospice, and identifying the appropriate physician to engage in advanced-care conversations with at-risk patients. To overcome these barriers, many provider groups are implementing predictive analytics to help them evaluate and understand their options around end-of-life care and hospice programs.
These analytic models analyze large amounts of data by applying artificial intelligence and machine learning algorithms to predict changes in patients’ conditions as well as the likelihood of various outcomes. By providing early identification of patients who are likely to need end-of-life or hospice care in the subsequent year, predictive analytics can drive cost savings while helping providers improve patient satisfaction with end-of-life medical care.
Understanding the advantages of hospice care
The final 30 days of life are generally among the highest-cost and least comfortable periods of a patient’s journey. For those nearing the end of life, hospice care is an increasingly in-demand option aimed at maximizing comfort for a patient who is terminally ill by reducing pain and addressing physical, psychological, social and spiritual needs. Hospice staff also provide counseling, care and support for family members who may be struggling with the prospect of a loved one’s death.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
In contrast to other forms of medical care, the goal of hospice care isn’t to cure a patient’s underlying disease; rather, it is to support the highest quality-of-life possible for whatever time remains for that patient, according to Mayo Clinic. Hospice care can be provided in a patient’s home or a nursing facility and is generally intended for patients who are expected to have fewer than six months to live, to help them die without pain, discomfort and stress.
Our data shows that the majority of patients who had more than 10 days of hospice care died more comfortably with minimal intervention in their final days of life. In contrast, patients who died without hospice care typically had some form of imaging (83%), took an ambulance ride (52%), ended up in the ICU (53%), and died in a hospital with critical care (53%).
Polls have consistently shown that most people prefer to die at home, with 71% of Americans confirming their preference in a Kaiser Family Foundation survey.
The demand from patients and families for better end-of-life care is expected to increase. End-of-life analytics can help providers launch or optimize effective end-of-life programs.
Using predictive analytics to inform end-of-life decisions
In addition to catering to demand for improved end-of-life care, hospice programs can generate significant cost savings for provider groups that properly implement them. Our data from Medicare Accountable Care Organizations illustrates the substantial variation in medical spend over the last 30 days of patients’ lives, depending on the amount of hospice care they experienced.
Patients with 10 or more days of hospice care average $7,500 in total utilization, compared to $20,000 for no hospice care and $18,000 for 0 to 9 days of hospice care. Since timely entry to hospice is key to achieving such significant savings from end-of-life and hospice programs, provider groups ought to consider implementing an end-of-life analytics program to:
Perform a pre-program assessment: Analytics can help provider groups learn how to fund and design their-end-of life programs. For example, an analytics application can help program administrators understand the number of their patients who died in the previous year and total spending in 30 days prior to their deaths, while also modeling potential savings had various percentages of those patients experienced hospice care. In many cases, the savings from achieving an adequate level of hospice utilization is so considerable that it equals the amount of investment required to start the program within a short time.
Identify patients who would benefit from hospice: Predictive analytics can identify patients who have a high likelihood of needing hospice care within the next year. This helps ensure chronically ill patients do not slip through the cracks as they bounce in and out of the hospital. Identifying patients who are nearing end of life and ensuring their PCP or primary clinical care giver is aware and ready to have an end of life conversation is key.
Target physicians for additional education: By examining primary care physician utilization of hospice, analytics enable program administrators to gain insight into which providers to target for education. In many cases, once physicians who underutilize hospice understand the unnecessary cost and patient impact of their referral patterns and see how they compare to their peers, they begin to use hospice more frequently. Another byproduct of this outreach is the ability to inform providers of instances in which they represent the most appropriate physician to engage in compassionate end-of-life discussions with certain patients.
If you don’t measure it, you can’t change it. Hospice utilization is a metric that providers should strive to increase because it embodies the opportunity to both lower costs and increase the quality of patient care. Through analytics applications that help them pre-assess end-of-life programs, identify the right patients who are candidates and target appropriate physicians for education, provider groups and ACOs can optimize end-of-life care and materially reduce costs.
Jacob Hochberg is the Executive Director of Customer Insights at Arcadia, the leading population health management and health intelligence platform. Arcadia transforms data from disparate sources into targeted insights, putting them in the decision-making workflow to improve lives and outcomes.
