How can I assess the Medicare hospice referral potential of a home health agency?

Filed under Key Questions
Originally published in Market Research Letter: September/October 2009

Q: How can I assess the Medicare hospice referral potential of a home health agency?

A: Begin by considering the number of patients who die on service at an agency, plus those who are referred to hospice, to be the end-of-life potential population.  Our research indicates that some home health agencies in Florida — which is probably the most clinically sophisticated hospice market — have 60% of this end-of-life segment referred to hospice.  If you subtract the number of hospice referrals for a given agency (as indicated on their claims’ discharge disposition) from this 60% figure, you arrive at the uncaptured hospice opportunity.

If a hospice is part of an organization that also has home health capability, this information can be collected from internal records. Furthermore, a chart audit could be performed on those patients whose initial Oasis assessment indicated that they had less than 6 months to live and were not referred to hospice during their episode of care. The review could uncover whether the possibility of hospice was discussed with the family, and if the patient/family was philosophically opposed to the hospice concept.  It is important that the home health staff conduct the review to add credibility to the findings.

If the hospice is not affiliated with a home health agency, Healthcare Market Resources offers a report that details the hospice referral potential for home health agencies.  Click here to see a sample of the report.  Once a hospice has identified a local home health agency as a candidate for becoming an end-of-life partner, it can approach that organization to educate them on the benefits of transferring that patient to hospice for both the agency and the end-of-life patient.