Bereavement Pastoral Care/ Chaplaincy Social Work Complimentary Therapies
1. Describe why holistic hospice care may be threatened in era of increasing financial and regulatory pressures. 2. Distinguish the difference between regulatory requirements, performance competency and performance standards.
3. Identify two or more methods administrators may use in calculating the cost and performance of each discipline. 4. Synthesize the insights presented in order to critically evaluate and make changes, if indicated, to modify cost and benefits.
Good Sense + Dollar Savings = WIN/WIN! Demographics Patient choice Ethical considerations Cost savings
Dame Cicely Saunders? Elizabeth Kubler Ross? Angelica Thieriot? Mary Tyler Moore?
Planetree is most simply a philosophy of PATIENT CENTERED CARE. It's doing what's right for the patient and their families FIRST, LAST and ALWAYS. “Since our founding by a patient in 1978, Planetree has defined what it means to be patient-centered.” Planetree’s international membership is comprised of more than 500 organizations from five countries.
Planetree philosophy: treating the whole patient—body, mind and spirit. An organization that develops and implements guidelines for patient-centered care.
The International Alliance of Patients' Organizations (IAPO) states: “The essence of patient-centered healthcare is that the healthcare system is designed and delivered to address the healthcare needs and preferences of patients so that healthcare is appropriate and cost-effective.”
Others also have patient- centered goals Increasing expectations for accountability Pressure from “hospice-like” alternatives Anticipated bundled payment models Value-based purchasing Everything is questioned and therefore must be measured/ quantified/ valued
Social Work Pastoral Care Bereavement Alternative/Ancillary/Complimentary Therapies Showing up was appreciated; often adequate
Regulatory Requirements Competency Requirements Performance Standards Each of the above is different and must be addressed for each discipline
Title 42: Public Health PART 418—HOSPICE CARE REVIEW: OIG Compliance Program, Guidance for Hospices-- Federal Registry/ Vol. 64 No. 192/Tuesday, October 5, 1999/Notices
Competencies are identified behaviors, knowledge, skills, and abilities that directly and positively impact the success of employees and organizations. Competencies can be objectively measured, enhanced, and improved through coaching and learning opportunities.
Specific performance expectations for each critical job responsibility. They explain how the job is to be done, plus the results that are expected for satisfactory job performance. They tell the employee what a good job looks like. The purpose of performance standards is to communicate expectations.
Documentation will include x/y/z Clinical visit activity will be recorded within y timeframe A fulltime employee will make x- y patient contacts per day/week/month.
The way we spend our health care dollars does NOT always make sense!! An estimated 20-30% of Medicare spending has been demonstrated to be Wasted/unnecessary/duplicative
The perceived and measurable benefits need to exceed the burden (cost) of the service Cost per Visit Cost per Day of Care Cost per Patient Served
Total* Discipline Costs/ All Visits Made = Cost per visit Total Discipline Costs/ Total Days of Care = Cost per DOC Total Discipline Costs/Total patients served = Cost per PS *Total= Direct and Indirect Costs
$ 45.00 (2080 x $45.00 = $93,600) $ 70.00 $100.00 $150.00 Would YOU pay for YOU ?
Access to Medicaid/Services/Benefits Decrease in Spiritual/Emotional suffering Improved Coping for Survivors ____________________________? What role might VOLUNTEERS play?
Impact on Admissions/LOS/ Hospital Re-admissions Patient and Family Satisfaction Team Performance Fundraising & Constituent Services
It All Depends… Is the task needed? required? desired? What does it cost to administer program? What is the value (the BENEFIT) provided? What is the value (the BENEFIT) added?
Medicare is the primary payment source Medicare is seeking to reduce payments Reimbursement not keeping pace with costs CAN YOU HELP SOLVE THIS CHALLENGE? Reduce cost Improve performance Be open to new delivery models
Regulatory Requirements- Documentation REALLY Matters Competency- It MUST be Demonstrated Performance- Keep ONLY the Best Not all will make it in an era of greater accountability!
Performance Behavior Grid Consider adding? Discuss with CT From Accountability Webinar ( Barrett/ Tilley 2011)
Pastoral Care/ Bereavement Social Work Music Therapy
Pam Barrett P Barrett & Associates LLC www.pbarrettassociates.com (Dollars and Sense: Valuing the Counseling Disciplines; All Rights Reserved)