Dan Kohl

With all of the talk of the sequester and Obamacare lately, I thought it would be a good time to revisit a study completed at Duke University in 2007 that outlines the many benefits of hospice and compare it to a new study out of Mount Sinai published in this month’s issue of Health Affairs.

The Duke study concluded that hospice reduces Medicare spending by $2,309 per person at end of life.

Background on the Duke study 

In 2006, MEDPAC analyzed when most Medicare dollars are spent. They determined that 25% of Medicare spending occurs in the last year of life. Researchers at Duke’s Sanford Institute of Public Policy then decided to analyze the costs to Medicare for people who died from 1993 to 2003. They compared hospice users to non-hospice users who were otherwise similar in age, race, gender and health conditions. For hospice users, the median length of time on hospice was just 15 days.

Key Findings:

• An overall savings of $2,309 per hospice patient.
• For seven out of ten hospice patients, the savings to Medicare would have been even greater if the patient had been admitted to hospice sooner.
• The day-to-day costs of patient care were reduced for most days during the last three months of life when hospice was involved with the case.
• The average cost to Medicare was $7,318 for hospice users and $9,627 for non-hospice users beginning with the day the hospice user was admitted as a patient.
• When the primary medical diagnosis is cancer Medicare’s savings after eight weeks of hospice care is almost $7,000.
• A non-cancer hospice beneficiary savings was about $3,500 over the last seven weeks of life.

The new Mount Sinai study shows that hospice results in better quality care and reduced cost.

The study shows that hospice enrollment:

• lowers Medicare expenditures
• lowers hospital Intensive Care Unit (ICU) use
• lowers 30-day hospital re-admissions
• lowers in-hospital death

The study at Mt. Sinai further showed that if 1,000 more Medicare beneficiaries were to enroll in hospice at least 15 days prior to the end of life, Medicare could save an additional $6.4 million. The researchers went on to say, “Building upon prior studies of hospice and palliative care that have demonstrated higher quality and improved patient and family satisfaction [these findings suggest] that hospice and palliative care are critical components in achieving greater value through health care reform: namely, improved quality and reduced costs.

Hospice Savings and Medicare

The primary savings for Medicare comes from reducing hospital admissions. Instead of dying in a hospital intensive care unit, hospice care allows people to receive care at home through the end of life. That is where surveys by the National Palliative Care and Hospice Organization find 83% of people want to die if given that choice.

The bottom line is that an early admission to hospice improves quality-of-life for the patient and family while providing a significant cost savings to Medicare.

You can read the full Duke research study, “What Length of Hospice Use Maximizes Reduction in Medical Expenditures Near Death in the US Medicare Program?” here and download the Mount Sinai study here.

Dan Kohl

While hospice use in the United States is growing, there are challenges for patients, families and hospice agencies when it comes to utilizing the Medicare hospice benefit. In an article titled “On the Way to Hospice, Surprising Hurdles” at NYTimes.com, Paula Span does a terrific job highlighting some of the barriers that exist – and I’d like to share a few additional thoughts.

While challenging, the earlier the hospice conversation takes place the better. Patients and families truly benefit from the hospice process and we need to make sure every patient and family gets the opportunity. I outlined some of the clear benefits of hospice care and some suggestions for having the conversation in my September blog post “The Hospice Conversation Can Be Difficult…But It’s Worth It.”

Patients, families and physicians should err on the side of getting hospice involved as early as they can. They should give hospice the opportunity to see if they can figure out the best way to provide care for the patient. While the regulations are clear and the reimbursement process is always challenging, hospices are devoted to providing excellent end-of-life care for patients and families. We’ll account for the financial challenge, and if we can find a way to make it work, we will.

Never lose sight of the fact that hospice is not only good for patients and families…it also saves a tremendous amount of money. With all of the pressure that healthcare costs put on our economy…hospice is a cost-effective way to keep patients out of the hospital and helps to avoid costly, unnecessary treatments.

A study conducted by researchers at Duke University found that hospice reduced Medicare costs by an average of $2,309 per hospice patient. Additionally, Medicare costs would be reduced for seven out of ten hospice recipients if hospice was used for a longer period.

There needs to be changes to the hospice benefit going forward so that it encourages patients and families to utilize it. Changing the eligibility to include palliative treatments and increasing reimbursement for hospice providers will undoubtedly increase the number of patients seeking hospice…and reduce the number of patients chasing curative treatments that are so costly.

Hospices really can handle hurdles…but, how much more effective would it be if the hurdles didn’t exist at all?

Halcyon Hospice offers physical, emotional and spiritual support, providing quality end-of-life care for you and your loved ones. For more information about our services, visit our website or call us at (855) 328-1700.

Grace Hospice was founded by the mother and daughter team of Betty Steedley and Sharon Cunningham. Grace’s current service area includes the following counties: Lowndes, Brooks, Lanier, Berrien, Thomas, Colquitt, Cook, Echols, Clinch, Atkinson, Ware and Tift.

“Grace Hospice has an outstanding reputation for providing top quality patient care and customer service,” says Dan Kohl, CEO of Halcyon. “We’re delighted that Betty Steedley and Sharon Cunningham, the former owners, will be on board to help us grow the South Georgia territory and honored for the opportunity to continue their top notch level of service.”

Halcyon Healthcare was formed in 2010 by HEP, Dan Kohl and Jack Draughon to build a leading hospice and home health company in the Southeastern U.S. The Grace transaction marks Halcyon’s third acquisition since our formation with prior transactions of Compassionate Hospice and Altus Healthcare & Hospice in 2011. As we continue to grow, we will be expanding throughout the southeast United States.

About Halcyon Hospice – Based in Atlanta, Georgia, Halcyon Hospice was launched by an experienced team of healthcare leaders in 2010. We truly believe that terminally ill individuals deserve to live pain and symptom-free in the company of family and friends and we are dedicated to providing the highest quality hospice services for our patients and their families.

Halcyon provides inpatient hospice, hospice in facilities, crisis care, palliative care and bereavement and support services. For more information, or to find a Halcyon Hospice location near you, call 855-328-1700 or visit our Locations Page.

Media Relations: Contact Jennifer Brooks at Jennifer.Brooks@halcyonhealthcare.com.

Halcyon Completes First Acquisition in South Georgia

Halcyon acquires Grace Hospice, increasing coverage by twelve counties

VALDOSTA, GA: Halcyon announces the completion of the first hospice acquisition in South

Georgia. The acquired company is Grace Hospice, located in Valdosta, GA.

Halcyon was formed in 2010 by Health Evolution Partners (HEP), Dan Kohl, and Jack

Draughon. The goal was to build the leading hospice and home health company in the

Southeastern U.S. Halcyon completed their first two acquisitions in 2011, covering more than 40

counties in North Georgia. This acquisition marks the first entry into South Georgia, expanding

the footprint of Halcyon by twelve counties.

“We decided to sell to Halcyon because we were excited about the potential to build the leading

hospice in South Georgia.” Says Sharon Cunningham, one of the former owners of Grace

Hospice. “We look forward to working with the Halcyon team.”

Halcyon will initially operate under the Grace Hospice name and provide the same level of

outstanding service that patients and families have become accustomed to receiving.

About Halcyon Healthcare

Halcyon Healthcare seeks to become the leader in delivering the highest quality, cost

effective hospice and home health services utilizing information to improve clinical

outcomes and provide peace of mind for the patient. For more information contact Dan Kohl

(danathalcyonhealthcaredotcom) or Jack Draughon (jackathalcyonhealthcaredotcom).

About Health Evolution Partners

Health Evolution Partners invests in rapidly growing companies that are commercial leaders

in the health care industry, including: Hospitals, physicians, managed care, pharmaceutical

developers, device makers and consumer products and services. Health Evolution Partners is

guided by a team of exceptional health care investors and operators. We connect our companies

to an unparalleled network of health care innovators, policymakers and thought leaders. We

bring both financial resources and mindshare to our companies. Health Evolution Partners forms

close working partnerships with outstanding management teams who are building important and

valuable enterprises. We align our success with our companies as they grow and prosper. For

more information on Health Evolution Partners, visit www.healthevolutionpartners.com.

Before I began my career in hospice, I was an Oncology nurse. I saw patients dying and their families were unaware of the totality of their illness. I believed that everyone deserved a positive end-of-life experience and that there had to be a better way to transition to the next phase of life. That desire led me to hospice. I went home after working a 3-11 shift at the hospital and looked up “hospice” in the yellow pages. That was fifteen years ago, and it was the beginning of my hospice journey.

Recently I read an article in the Atlanta Journal-Constitution called, Families Face Difficult Decision as Hospice Care Grows in Georgia. The article, written by Sheila Poole, talked about a family’s decision to allow hospice care providers into their home. The article noted that hospice care has doubled in the United States since 2000. When I began my career in hospice in 1997, 450,000 people were receiving hospice care. Today there are 1.6 million patients receiving the hospice benefit.

The hospice provider community has also grown. There are at least 3,400 hospice organizations in the United States. Studies have shown that for every one dollar that Medicare spends for hospice care, they save one dollar and twenty-six cents. The National Hospice and Palliative Care Organization estimates that 41% of all deaths in the United States occur under the care of a hospice program. Studies have also shown that severely ill patients introduced to hospice earlier in their disease process have an increase in their quality of life. Overall, hospice is a compassionate and humane way to deliver quality health care and supportive services to people at the end of their lives.

Growing up with a mother who’s a minister, I was raised in a home that believed in giving and serving. My mother would take me with her when she spoke at homeless shelters, convalescent homes, and institutional facilities. She wanted me to learn how to appreciate life and the blessing of giving. Her example provides me with insight into my passion for end of life care. I appreciate life. I appreciate my husband, James, my daughters, Portia and Sydney and my parents Lucius and Gloria Glynn.

Over the past three years, I lost my grandparents, Inez Glenn and Earnton Mosley, along with my daughters’ grandmother, Minnie Cato. They transitioned while under the care of hospice. Their transitions were very difficult for me. Their value to my life was immeasurable. I felt solace in knowing that they transitioned peacefully and comfortably; that’s the blessing of hospice.

I have a great appreciation and admiration for hospice from a personal and professional viewpoint. My role as Director of Clinical Operations at Halcyon Hospice is to ensure that our caregivers have the knowledge, skill and compassion necessary to provide every patient and their family a positive end-of-life experience.

Now when I’m asked why I chose hospice as a career, I respond with confidence, “Hospice teaches me how to live, how to give, to not sweat the small stuff, and how to appreciate every aspect of life”.

Do you have suggestions for topics you’d like to see covered on our blog, or a story about your loved one that you want to share with others? Please send us your ideas and stories.

I started my career in the healthcare industry as an investor.

Hospice was an easy choice for me. While Dan and I share an intense professional belief in the tremendous opportunity for improvement in our industry, hospice is also of personal interest to me. In 2005, my middle daughter, Caroline, was diagnosed with a rare brain disorder. Her prognosis was grim. Caroline’s health deteriorated quickly and within weeks my wife and I no longer could care for her without assistance. I am forever indebted to the compassionate hospice nurse, Bonnie, who provided support and administered the many medicines Caroline needed to live her last few weeks comfortably and, ultimately, to pass peacefully. Bonnie was kind to us and truly was the rock in our family during the most difficult time in my life.

Our vision for Halcyon is to provide the same outstanding care and support that Caroline and my family experienced during her illness. My first-hand experience with hospice reminds me every day that excellent care is Halcyon’s number one goal. It is no accident that I have a business partner in Dan who shares these core values and vision. We are both excited about the future and believe Halcyon will ultimately become a model in the industry, with employees who strive for excellence and patients who are confident our service is superior to that of our competitors.

The future at Halcyon Healthcare and Hospice is bright. Thanks for stopping by. 

- Jack

This post was originally published on the Halcyon Hospice Blog. 

Last week was a big one for healthcare policy in the United States. The Supreme Court ruling upholding the Patient Protection and Affordable Care Act (PPACA) was considered a political victory for President Obama. So what does the ruling mean for patients and families utilizing the Hospice benefit? Here’s a quick summary:

• Hospices will be required to begin collecting consistent quality data and reporting on it in 2014.  Most hospices are tracking some quality measures now and the introduction of a consistent approach will be beneficial to patients, families, and hospices seeking to improve care.
• Currently when a patient is admitted to hospice, the hospice organization must obtain certification from a physician that the patient is terminally ill and has a life expectancy of less than six months. Under PPACA, hospice organizations are required to obtain re-certification by a hospice physician or nurse practitioner prior to the patient’s 180th day on service and in each subsequent service period. This process has been in place for some time and, while it is an added cost burden, it does help keep the focus on length of stay.
• After October 2013, reforms to the payment methodology for hospices will be considered. Utilizing data, consideration will be given to the rates currently in place and whether the structure of those rates will need to be adjusted.  The changes are to be budget neutral…but, we’ll see what they look like as the deadline approaches.

I don’t believe there are simple answers to the challenge of reducing healthcare costs in the United States.  I do believe that focusing on those programs that offer the opportunity to provide high quality care at the lowest price should continue to be invested in….particularly hospice and home health. Hospice organizations have always been committed to providing high quality service in a caring and compassionate way to patients with a life limiting illness.

The PPACA will not change that.  Supporting patients and their families during the most difficult moments of their lives and doing it cost effectively is what drives most hospices. Provided that the changes ahead focus on quality and excellence…balanced with an eye toward cost…patients will continue to benefit.

To learn more about hospice, vist Halcyon Hospice on the web or on Facebook. 

“These transactions represent the critical first steps for Halcyon in establishing a differentiated hospice and home care company focused on high quality, cost effective outcomes,” said Dan Kohl, CEO of Halcyon. “Both Companies provide exceptional care through teams of dedicated employees, consistently delivering peace of mind to patients and families. We’re excited about the opportunity to build something special.”

“The Compassionate and Altus acquisitions are highly complementary and provide a solid foundation off which Halcyon will be able to further build upon through additional acquisitions,” said Jay Rose, Principal at HEP. “We look forward to supporting and funding additional growth.”

The Braff Group, a leading merger and acquisition advisory firm specializing in health care services, acted as financial advisor to Compassionate Hospice and HH Advisors, a boutique financial advisory firm, acted as advisor to Altus Healthcare & Hospice.

About Halcyon Healthcare

Halcyon Healthcare seeks to become the leader in delivering the highest quality, cost effective hospice and home health services utilizing information to improve clinical outcomes and provide peace of mind for the patient. For more information contact Dan Kohl (dan@halcyonhomehealth.com) or Jack Draughon (jack@halcyonhomehealth.com).

About Health Evolution Partners

Health Evolution Partners invests in rapidly growing companies that are commercial leaders in the health care industry. We invest in all key sectors of the health economy: hospitals, physicians, managed care, pharmaceutical developers, device makers and consumer products and services. Health Evolution Partners is guided by a team of exceptional health care investors and operators. We connect our companies to an unparalleled network of health care innovators, policymakers and thought leaders. We bring both financial resources and mindshare to our companies. Health Evolution Partners forms close working partnerships with outstanding management teams who are building important and valuable enterprises. We align our success with our companies as they grow and prosper. For more information on Health Evolution Partners, visit www.healthevolutionpartners.com .

SAN FRANCISCO, CALIFORNIA, December 15, 2010 – Health Evolution Partners (“HEP”), announced today that the Health Evolution Partners Growth Fund, along with Dan Kohl and Jack Draughon, launched Halcyon Healthcare, a new company being formed to deliver the next generation of home health and hospice care solutions based upon clinical excellence and coordinated care delivery.   Halcyon will focus on acquiring and building a network of home health and hospice agencies that deliver high quality, cost effective outcomes generated by clinically driven, information based care.

Dan Kohl will serve as Halcyon Healthcare’s Chief Executive Officer.  Dan has over 30 years of experience leading public and private health care services companies.  Mr. Kohl is the former CEO of two home health companies Pediatric Services of America and Housecall Medical Resources.  Dan will be joined by Jack Draughon, an experienced health care investor who most recently led the U.S. health care investment practice of Arcapita Bank B.S.C.(c).  Mr. Draughon, who will co-lead the effort and serve as Chief Development Officer brings significant experience in the home health industry, including leading Arcapita’s successful investment and subsequent sale of TLC Home Healthcare Services.

“As we look at the challenges in our health care system, it is clear that home care has a lot to offer.  We envision the home as a prime setting for care using clinical excellence and information technology,” said HEP Chairman David Brailer.  “We look forward to working with Dan and Jack to build a company that will redefine how home care is delivered.”

“The current environment presents a unique opportunity to build a best-in-class home health care platform,” Kohl said.  “The regulatory and reimbursement environment clearly favors providers that emphasize care improvement and cost containment—elements central to our mission. These values are core to Health Evolution Partners’ investment philosophy and along with their deep industry knowledge and relationships make HEP the ideal partner in this endeavor.”

“We are excited to partner with a premier executive team,” said HEP Principal Jay Rose. “Dan and Jack bring exceptional operating and acquisition experience that we believe will be critical in building a transformative service model focused on not only high quality, episodic care but also ongoing chronic care management.”

***

About Halcyon Healthcare

Halcyon Healthcare will be the leader in delivering the highest quality, cost effective home health services and information that result in improved clinical outcomes and peace of mind for the patient.   For more information contact Dan Kohl (dan@halcyonhomehealth.com) or Jack Draughon (jack@halcyonhomehealth.com).

About Health Evolution Partners

Health Evolution Partners invests in rapidly growing companies that are commercial leaders in the health care industry. We invest in all key sectors of the health economy: hospitals, physicians, managed care, pharmaceutical developers, device makers and consumer products and services. Health Evolution Partners is guided by a team of exceptional health care investors and operators. We connect our companies to an unparalleled network of health care innovators, policymakers and thought leaders. We bring both financial resources and mindshare to our companies. Health Evolution Partners forms close working partnerships with outstanding management teams who are building important and valuable enterprises. We align our success with our companies as they grow and prosper. For more information on Health Evolution Partners, visit www.healthevolutionpartners.com.

Please Contact:

Julie Murchinson

415.362.5800

media@healthevolutionpartners.com