MDNews - Greater Boston

Q How does HopeHealth work with hospitals and physicians to help provide care for people with serious illness? A: It's fundamental to our strategy and overall approach as an organization to work with everyone else in the healthcare system. Many patients eligible for hospice care never use those services. We reach out to that population and make sure they're getting the services they deserve. Q How does HopeHealth's Open Door Philosophy work? A: It's an approach we initiated approximately five years ago. We were not reaching all the people in our community we should have reached. We were geographically a hospice organization on Cape Cod, and only about a third of the eligible people were receiving hospice services. This new Open Door Philosophy was our commitment to increase access to care, breaking down traditional barriers. We expanded our admissions criteria to be as open as the rules would allow, taking patients regardless of the complexity of care needs or the cost of their care. We've gone from serving 80 patients a day to 350 patients a day. As we have added more service lines, we've maintained that Open Door Philosophy. Q What are the most significant financial challenges facing HopeHealth in 2014? A: The majority of the patients we serve are elderly, so Medicare is the bulk of our income. Anything that impacts Medicare impacts us. There are two main challenges: The Affordable Care Act reduced Medicare payments to providers, and federal budget sequestration brought an additional rate cut. That isn't going away. Each year, it becomes more challenging. Q What is the most important factor for healthcare leaders to consider when facing these types of financial challenges? A: I have never experienced any change that is as far-reaching and fast as the changes sweeping through U.S. health care now. What is changing almost overnight is a shift from volume to value. Outcomes and costs are the key factors. Any healthcare executive has to be contemplating ways to provide care that achieves high quality in a cost-effective manner. The resource that is applied to the patient has to be the right resource. Q How is HopeHealth positioned to cope with the changing healthcare environment? A: We developed a strategic plan about five years ago to expand the reach, scope and impact of our services. Our geography expanded to include Plymouth, Bristol, Norfolk, Suffolk and Dukes counties. We needed a larger pool of patients to expand the risk associated with the Open Door Philosophy. It's a relatively small number of patients who drive the costs. We needed to look at innovations in serving that group of patients. We also merged with Alzheimer's Services of Cape Cod & the Islands. That's a population with a significant burden for caregivers. In Barnstable County, there are 10,000 people with Alzheimer's or other dementia. And Hope HouseCalls is physician primary care provided in the home. Illness can make it impossible to access primary care on a regular basis. This service cuts down on 911 calls, emergency room visits and repeated hospitalizations. We are able to prevent that cycle from continuing. Q Why did you go through a rebranding effort a couple of years ago? A: We really had to reinvent the organization. Historically, it had been a hospice organization. We had expanded and diversified. In 2010, we expanded off Cape and added new services for people with chronic conditions. We became HopeHealth and were able to develop a consistent family of brands, while focusing on the broad mission of being an organization that serves patients with serious illnesses. Q What is the outlook for HopeHealth in 2014? A: It's going to be both exciting and challenging. The changes taking place are very much for the good. But we need to make adaptations, changes and adjustments in a context where our core reimbursement rates are being reduced. We're serving our patients in an environment where we have to be costeffective while focusing on that broader mission of being an organization that serves patients with serious illness. I The CEO Edition I MD NEWS Greater Boston | 15

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