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Hospice Referrals Depend on Each Physician’s Knowledge, Advocacy and Practices


While hospice care can be requested by anyone, a patient’s physician remains a key resource where authority, trust and expertise can make all the difference in making a hospice referral a timely, supportive and beneficial experience for both patient and family. For this reason, Mike Ferris, Principal, Simione Healthcare Consultants, tells hospice teams, and specifically those working in sales, to examine each physician’s feelings about hospice, knowledge of hospice, and patient management practices.

Ferris recommends a sophisticated approach to growing physician referrals with less cost using the Simione Referral Partner Barometer, a methodology that will help hospices expand physicians’ use of their services.  “We want to help hospice teams generate more referrals while reducing the cost per referral,” he explains, “and that requires better planning to become a pre-acute care provider in the minds of their hospice referral partners.”

Historically, physicians do not often refer patients to hospice from their practices, according to Ferris:  they look at hospice as a post-acute resource even though much can be done to help patients appropriate for hospice before a hospital stay.  They are content allowing the hospital discharge planners to make the referrals to hospice.  “What’s wrong with this picture?  A patient has to have an acute enough exacerbation to be hospitalized before anyone considers hospice.  Hospice can lead to greater quantity and quality of life, but only if the patients are identified in time.”

Simione Referral Partner Barometer offers a way to drive strategy to increase the number of hospice referrals received directly from physicians.  Within three realms, the Barometer methodology directs hospice providers get to know physicians in their market, and more specifically:  how they feel about hospice, what they know about hospice, and how they manage their patients. Through a series of ratings, the Barometer helps classify physicians based on how supportive each one is of hospice, and how hospice fits into the way they treat their patients’ diagnoses.  “Is this physician comfortable referring to hospice and having the ‘hospice conversation’,” suggests Ferris, “How much do they know about hospice, and how involved does the doctor want to be in the management of his or her patient’s hospice care?”

Along with asking other similar questions, hospice organizations can determine which elements are most important for every physician partner to determine a value proposition that resonates with him or her. “Physicians must understand the benefits of hospice in a way that is individually meaningful to them, whether it be time saved in their office, staying better informed about their patients, or reducing pressure from hospitals related to re-hospitalization,” Ferris says.

“If you want to expand the referral community’s use of hospice services, find out what is important for each physician – his or her needs, problems, challenges and frustrations. Take the time to interview them carefully to see what you can do to earn their business,” he adds.

The same approach to other referral partners – discharge planners and other providers – will also help overcome gaps in understanding and common objections to hospice referral and admission.  “You have to convey the benefits of hospice in such a way that those affected can make an educated decision when the time is right,” Ferris says.