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Sen. Sheldon Whitehouse (D-R.I.) and CMMI Director Adam Boehler Visit Rhode Island to Discuss Advanced Care Innovation

C-TAC member HopeHealth provides hospice, palliative care, and home health care for over 1,500 patients every day in Rhode Island and southeastern Massachusetts. Sen. Sheldon Whitehouse (D-R.I.) and Center for Medicare and Medicaid Innovation Director Adam Boehler recently met with HopeHealth President & CEO Diana Franchitto. On March 29, C-TAC Senior Policy Advisor Andrew MacPherson sat down with Diana Franchitto to discuss the visit and her goals for HopeHealth, going forward.

Andrew MacPherson: Thank you for taking the time to speak with us, Diana. Could you tell us how this meeting with Sen. Whitehouse and CMMI Director Boehler came about?

Diana Franchitto: The initial meeting was between Sen. Whitehouse and I. The primary purpose was to discuss the Rhode Island Quality Institute, the State’s Health Information Exchange, where I serve as Chair of the Board. This was followed by a visit from CMMI Director Boehler, who Sen. Whitehouse had invited to learn more about Rhode Island’s multi-pronged efforts related to end-of-life care and supporting people facing advanced illness and their families. Director Boehler’s visit was part of a day full of activities designed to give him an update on key Rhode Island initiatives and offer some food for thought when he thinks about CMMI funding in the future.

Andrew MacPherson: What projects did you focus on during your discussions with Sen. Whitehouse and Director Boehler?

Diana Franchitto: Sen. Whitehouse and I focused on the strategic direction of the Rhode Island Quality Institute during our initial meeting. When we were joined by Director Boehler, I had the opportunity to share one of HopeHealth’s educational initiatives, Complex Care Conversations.  This is an interactive training to increase clinical ease and effectiveness to talk with patients dealing with serious, progressive illnesses.  There will never be, in the foreseeable future, enough palliative care specialists to manage the demand that will be placed on them. It’s clear that training our clinical community is so important in terms of developing a comfort level and skill in this sensitive subject so that conversations are not delayed or postponed.

We are pleased to say that the program has trained 660 clinicians, over 90 percent of whom felt somewhat or very skilled with all aspects of complex care conversations after the training, nearly a 50 percent increase from the 44 percent pre-training. The project has led to clinicians feeling more fulfilled. 85 percent of participants said that the training improved their satisfaction in caring for patients with serious advanced illness.

Andrew MacPherson: How did Sen. Whitehouse and Director Boehler react to hearing about the Complex Caring Conversations project? Did Director Boehler indicate if this type of training would be included in models released by CMMI going forward?

Diana Franchitto: They were really pleased. There was also a recognition that a systemic approach to training is what’s needed throughout this state and country when you think of the vast numbers of clinicians who could benefit from learning this skill. Director Boehler did note that this kind of training could be an important aspect of future funding.

We also spoke about the nonprofit hospice community, which must be considered a hospice safety net for the United States. HopeHealth and non-profit hospices around the country provide care  to patients and their families, no matter their level of insurance or living situation, including homeless shelters. 

Andrew MacPherson: Looking to the future, what would you say is your greatest concern? Additionally, is there anything you are particularly hopeful about regarding the future of the field?

Diana Franchitto: As with all health care organizations, funding for services is a concern. When I see the recent MedPAC recommendations for hospice and home care reimbursement cuts, it’s of great concern.  Health care systems are relying on their home care and hospice partners to bring financial value and deliver an incredibly important service to patients and their families when time matters most.  The expectation that you can do this in the wake of cuts is complete dissonance, especially for the non-profit community.

However, I’m optimistic about the potential for the hospice and palliative care community to partner with the entire health care system. The hospice and palliative care sector can contribute mightily to some of the most serious problems our health care system is facing.  Developing collaborations that meet the needs of our partners in a meaningful way is, I believe, where the future of serious illness care is going.

For more information about HopeHealth, please click here.

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