Hospital Referrals: Strengthen Relationships & Grow Your Baseline

Hospital Referrals: Strengthen Relationships & Grow Your Baseline

Hospital Referrals: Strengthen Relationships & Grow Your Baseline

Guess how many of the 15% of hospital discharges meeting the eligibility for their hospice benefit are taking advantage of it? Only 50% and it’s up to you to increase that number. Kurt Kazanowski covers 11 tactics to help you grow your hospice program by getting referrals from hospitals in a  recent HHWN webinar. Given that hospitals are the largest end-of-life providers, let's learn more about how they receive their compensation and how you can use that to help you get referrals.

First, how does a hospital make money from a hospice patient? When a Medicare patient is admitted, they are assigned a specific diagnostic related group (DRG), by a DRG grouper. The grouper determines the correct DRG by looking at the principal diagnosis, co-morbidities and complications, surgical procedures, age, gender, and discharge disposition.  A hospital gets its money from assigning these DRGs for reimbursement by Medicare.  There are many possible DRGs, listed here.

Each DRG has a specific projected length-of-stay (LOS) as well as a payment amount based on locality. A hospital in Denver, CO will not receive the same payment amounts as a hospital in Helena, MT. It is up to the hospital to manage the patient, so they don’t exceed the LOS.

Here is a scenario for a  patient admitted to the hospital for DRG #313 (chest pain). The LOS is five days and the hospital will be paid $5,000. It doesn’t matter if a patient stays in the hospital for one day or nine days, the hospital will only be reimbursed for the first five days in the amount of $5,000.

Now that we understand how hospitals make their money, we can get back to how to get referrals from a hospital. You must be able to show the value you’re providing to the people entrusting your hospice program with their care. You’ll need to make the hospital (and everyone working there) know why working with your agency is an asset and the best thing for their patients. This is called value proposition, and commonly revolves around:

  • Reduction in expenses: If a patient stays beyond the LOS for their DRG, the hospital cannot get more money for their stay. If the patient is eligible for their benefit and the hospital refers them to a hospice, the hospital would then be off the hook for that patient’s expenses.
  • Reduction in mortality stats: Mortality rates at hospitals are one of the key indicators that they track. By bringing a patient into hospice care, they are no longer considered a part of the hospital's mortality rate.
  • Increase in patient satisfaction: As a general rule, patients who are in hospice care are happier than those who choose not to elect their benefit.
  • Lowering litigation risk: Hospices are rarely ever sued. One key selling point for attorneys, risk management personnel, quality assurance groups, etc. is that by working with hospice they can mitigate their chances of a lawsuit.

Anyone from the CEO to a hospital volunteer can make a direct referral or can be an influencer for you. It is important to remember that to get referrals you need to get to know all staff members. Although a medical staff secretary is not someone you would initially think to speak with, they can become a key influencer for your hospice. This person constantly works with physicians, and they can explain to not only physicians but other staff members the benefits of hospice care. The more influencers you have will directly correlate to how many referrals you receive.

Understanding the different value propositions that exist in a hospital and its surrounding campus is key to success. In Kurt’s webinar, 11 Tactics to Grow Your Hospice with Hospital Business, he delves into this topic in greater detail and lays out the steps to implement to make sure your hospice is thought of first when someone needs to elect their benefit. 

Use code REFERRALS at checkout for 10% off this webinar! This coupon is valid through December 2022.