Appealing to Caregivers Can Spark Earlier Engagement, Longer LOS

Anyone who has worked in the field of hospice and palliative care knows that patients often come onto these valuable programs woefully later than they should. Hospice, unfortunately, is largely viewed as care for the very last weeks or days of life. Palliative care is misunderstood and frequently viewed as being the same thing as hospice. Sadly, the latest Medicare data shows that more than 40 percent of hospice patients receive the hospice benefit for 14 days or less.

This under-utilization of hospice brings challenges related to short lengths of stay. With cost-of-care its highest at the beginning and end of the care cycle, a shorter “middle period” creates a crunch in reimbursement that translates to razor thin operating margins – or even financial losses.

Another disadvantage is that when patients receive hospice care for only a few days, they and their families don’t experience the full impact of what providers can deliver. This lack of opportunity for the provider’s full capabilities may affect the family’s perceptions of hospice care and even potentially lower evaluation scores.

During the past 20 years of promoting hospice care, Transcend Strategy Group has found it consistently difficult to change attitudes in getting patients and referrers alike to accept it’s time for hospice care as early as they should.

But, we’ve applied another strategy with considerable success – appeal to the family caregiver for support in caring for their loved one at home. When you convince the family caregiver you can help ease their challenges, they tend to raise their hands sooner to receive support.

The needs of family caregivers are only going to increase in the future. In fact, our nation is in the early stages of an escalating caregiver crisis. As the tidal wave of Baby Boomers continue to age and need more healthcare, that crisis is going to become even more urgent. And the urgency will be amplified as the shortage of professional caregivers is predicted to shrink, not grow.

Consider these sobering statistics:

• More than 40 million Americans currently provide care for a loved one at home
• By 2020, over 100 million Americans will need care assistance
• By 2030, there will be a national shortage of 151,000 paid direct care workers, resulting in 3.8 million unpaid family caregivers spending significant time to provide care
• By 2040, that shortage of paid care workers will increase to 355,000 with 11 million unpaid family caregivers picking up the slack

Now more than ever, providers of home-based care need to communicate they are not only experts in caring for patients, they are experts in helping family caregivers be more competent and confident in taking care of their loved ones.

And it will be helpful to communicate that your experts help take care of caregivers, too – providing support and respite to help relieve some of the caregiving burdens.

In more than 18,000 surveys Transcend has conducted with family healthcare decision makers (many of whom are also the primary caregiver for a loved one), this cry for support comes through loud and clear. Caregivers start with a sacrificial mindset, ranking “Helping the patient be more comfortable” as the most valuable service a hospice can provide. However, the next prioritized rankings include clear aspects that benefit the caregiver and family as well:

• Being available for 24/7 assistance
• Emotional support for the caregiver
• Teaching caregivers how to provide the best care
• Spiritual support
• Grief support

By crafting marketing strategies and messaging to target the needs and desires of family caregivers, Transcend’s clients have experienced gains such as these:

• 25 percent to more than 100 percent increases in admissions from family referrals
• 60 percent to 265 percent increases in ALOS
• 84 percent to 320 percent increases in patient days

Want to provide more care to more patients for longer periods? Start by promoting how you provide support for their family caregivers.