Hospice month recognizes benefit of patient-centered care model

By Phil Marshall

November is National Hospice and Palliative Care Month. Hospice was introduced a half century ago, but this year and next may be the most significant for hospice providers, and the patients and families we serve.

U.S. Congress is now actively reforming the Affordable Care Act, passed about six and a half years ago, by carefully considering the needs of those with advanced illness. Policymakers now recognize that access to both palliative and hospice care is in the best interest of seriously ill patients, their families and healthcare in general.

People with difficult-to-manage chronic illnesses want to be home among family and friends rather than make recurring visits to the hospital. They want pain managed rather than receive unwanted or ineffective treatments. They want their social and spiritual needs addressed to help reduce the stresses associated with their illness rather than feel isolated. And they want to avoid going into debt due to ever-increasing healthcare costs.

We know that about five percent of the population accounts for nearly half of all healthcare costs, and yet patients aren’t enjoying the quality of life they want and deserve.

Independence at Home

In July, legislation was introduced into Congress called the Independence at Home Act. This followed a national pilot program that showed seriously ill patients who were provided primary care where they live had an improved quality of life and saved millions of dollars in Medicare payments.

That medical model closely follows the one Hosparus helped pioneer and has been improving upon over the last 50 years. Our model is one where care is coordinated between all providers and settings and is consistent with the patient’s values, goals and preferences. It is one that addresses the physical, emotional, social and spiritual needs of the patient.

Larger Scope

Hosparus care providers travel more than two million miles each year across the 33 counties we serve in Kentucky and Southern Indiana to deliver this patient-centered care. This year, we will care for more than 7,000 patients and their families.

We believe so strongly that our model can help patients and families for years rather than months or weeks, that this summer we launched a pilot adult home palliative care program. This is for patients in our service area who no longer qualify for hospice care — or are not yet qualified — but could benefit from our team of providers.

2016 is also the first full year physicians are being reimbursed for discussing advance care planning with patients facing a serious illness. Although this kind of conversation can be very difficult, the stress and anxiety that accompanies a serious illness can be reduced by having a proactive discussion with a physician. This is also an ideal time to discuss a patient’s care goals and preferences.


In Kentucky, that time can also be spent completing the new Medical Orders for Scope of Treatment form (MOST). In Indiana, it’s called the Physician Orders for Scope of Treatment (POST). Both forms are intended to be completed under the guidance a physician when a patient faces a life-limiting illness or is medically frail.

As you can see, this has been a benchmark year for our seriously ill patient populations and providers like Hosparus who serve them. As 2016 rolls into 2017, we will be actively involved in helping to educate our elected officials at the national and state level on the benefits of patient-centered care. In the meantime, we will continue to explore new innovations and services to ensure patients and families get the care they need to live the best quality of life possible.

-Phil Marshall is president and CEO of Hosparus in Louisville, Ky.