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Innovations in Care: Brian K. Davis on Scaling for Workforce

The U.S. population is aging rapidly, with 10,000 Americans becoming eligible for Medicare every day. As the need for care increases, the healthcare workforce must adapt and scale to serve this population. During the 2018 National Summit on Advanced Illness Care, VITAS Healthcare Vice President Brian K. Davis, RN, will be sharing strategies for scaling for workforce to provide effective and efficient care for the advanced illness population. Learn more about his work below.

How would you define the problem you are addressing, with regards to scaling for workforce?

Our historical problem with scaling for workforce was offering a variety of services to accommodate different needs across our various markets.  We have adapted to accommodate demand and become more structured in our offerings which has allowed to strategically develop a human capital/staffing model that allows for scaling of a workforce within defined service models where there is more consistent demand.  Without the combination of a consistently, statutorily defined community-based palliative care service offering along with consistencies of payor/reimbursement models, an organization must be able to fully define their service offering and determine rules of engagement in order to determine what workforce disciplines are required and how to obtain, train, and retain them.

What do you think is missing in the current discussion on this topic?

Everyone has defined their palliative care offering based upon the entity identifying the need in the market and what their reimbursement structure is.  Therefore, there is little to no standardization making it difficult to recruit the right workforce and execute on the mission across the country.  When you add more complexity to the payment and service requirements, it raised the operating cost to conform.  If there was a more clearly defined Federal reimbursement structure along with a rules of engagement definition for community-based palliative care, the private market would be able to comply with those rules and apply them into their business model.

What would you like the audience at our upcoming Summit to take away from your session?

An organization cannot be everything to everyone.  It is difficult to provide all aspects of palliative care due to the different goals associated with each one and the large number of different reimbursement structures thus leading to confusion for the workforce.  The payment mechanism that aligns with your service offering is going to determine what your options are for workforce scaling.  Should you have the ability to utilize existing members of your workforce, through a different service line, you must determine training needs in order for the individuals to clearly and distinctly understand the goals of the service offerings they are providing.  Organizations will need to make strategic and sophisticated decisions that define their ability to scale.

What action, if any, would you like to see C-TAC take on this topic?

To help define and standardize what community-based palliative care is going to mean in the marketplace.  As with the formation of all service offerings and reimbursement regulations the details will be critical to ensure sustainability so that providers can clearly and distinctly identify the clinical disciplines that are required to deliver the offering in a high-quality, lowest cost fashion.  Finally, as these rules get established it will be critical to lift up a framework which incentivizes complementary services (ex. Hospice) which help to achieve the mutual goals of improving the patient and families care and experience within the high-cost patient populations these offerings are meant to service.

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