Busting The Palliative Care Loss Leader Myth - SMARTMD Busting The Palliative Care Loss Leader Myth - SMARTMD

Guest post by Mark Hendrix (@nTakthealthcare), Chief Executive Officer, nTakt

Hospice and Palliative Care in the United States are now over 50 years old. Originally founded to help patients manage symptoms associated with severe illness and end-of-life, providers deliver unparalleled care for those patients who need it most. Frequently, Healthcare organizations that serve Hospice patients offer Palliative Care as an extra level of support for patients who are not yet eligible for Hospice care. In fact, approximately 35% of all Palliative Care patients eventually become eligible for Hospice care.

In 1982, with the support of Medicare funding, the Hospice care business became self-sustaining. That has not been the case for Palliative Care, which continues to struggle to find a profitable revenue model, even though the need for palliative services has nearly doubled in the last decade. Constrained budgets force Palliative Care providers to function with a limited staff and work with insufficient tools to chart, schedule and monitor patients effectively. These tools and the processes they enable are perceived as critical by providers, and their scarcity creates a myth that Palliative Care is destined to be a loss leader in the operations of end-of-life care. Busting this myth would constitute a game-changer for patients and the providers who serve them.

Recent Changes

In recent years, several significant events are reshaping this Palliative Care landscape in a positive way:

  • Medicare Billing–CMS recently approved Advanced Care Planning and Non-Face-To-Face billing codes. These codes fund two central elements of the Palliative Care model and potentially double revenue per visit. For the first time in the history of Palliative Care, a provider can bill more than their salary. Although this is a financial game-changer, many providers are still not fully utilizing these codes.
  • Alternative Payment Models–Four Seasons Compassion for Life, for example, recently received a CMMI grant to recommend alternative payment models for Palliative Care. The results, however, are still being finalized their efforts are taking center stage in a movement to make palliative care independently sustainable business. Regardless of the outcome, the knowledge learned from this grant will be instrumental in defining a sustainable Palliative Care model.
  • Education–Attendance at the CAPC Annual Seminar continues to grow each year. CAPC promotes innovation by providing open communication forums and specialized training through their Leadership Centers and a Bootcamp for agencies starting Palliative Care programs. Opportunities to learn, grow and bust the myth are at an all-time high.
  • Technology–Although many technology companies have been reluctant to enter the Palliative Care market, several innovators have accepted the challenge and developed applications that help providers meet the specific needs of palliative patients.


Technology and efficient processes are central to sustaining the operations of any business. The following systems are examples of essential tools to busting the myth:

  • TapCloud (www.tapcloud.com) developed an application that allows providers to monitor home-bound patients between visits. It is a one-of-a-kind patient experience that engages the patient in their care plan and provides the clinical care team with a real-time summary of patient status. This allows the team to pro-actively address patient symptom issues while providing the patient peace of mind. Monitoring patient well-being has always been a struggle for Palliative Care, and TapCloud has busted the myth that face-to-face visits were mandatory to effectively care for patients.
  • Delta Care Rx (www.deltacarerx.com) is partnering with TapCloud to manage Palliative Care patient medications and potentially monitor the impact these medications are having on patient symptoms. In many cases, these medications can be electronically prescribed which eliminates paper prescription pads. This busts the myth that medication management must be performed on paper.
  • nTakt (www.ntakt.com) uses Lean Healthcare techniques to uncomplicate care processes so providers can focus on patient care. nTakt understands that no matter how game-changing the technology, results can only be achieved through a combination of simplified procedures, meaningful technology, and hands-on training. By eliminating unnecessary tasks and optimizing the most critical activities, Palliative Care agencies can perform at their highest efficiency and lowest possible cost. This ensures that the myth remains busted for years to come.
  • SMARTMD (www.smartmd.com) has developed provider friendly palliative EHR systems that simplify visit documentation, optimize palliative billing, and provides the flexible scheduling tools necessary for providers to care for patients in multiple settings. These tools free up time for providers so they can focus on what they enjoy most, caring for patients. SMARTMD also developed a referral and intake management solution that uses analytics software to populate management dashboards with referral status, visit metrics, and key performance indicators. These applications fill a critical missing piece of the palliative care puzzle and move us closer to busting the myth.


The leaders that shape the future of Palliative Care will be the ones who can and choose to utilize all tools, technology, and processes, currently available, to their maximum potential. The time is now for Palliative Care. The game has changed. The myth is busted. Who will take the lead and grab this quickly expanding opportunity?


Mark Hendrix (@nTakthealthcare) has spent the past 3 years as Project Operations Director for a $9.5 million CMMI palliative care grant. The grant focused on standardization of palliative care processes, improving patient outcomes, and developing alternative Medicare reimbursement models. In addition to staffing the model with Nurse Practitioners, Nurses, Social Workers, Chaplains, and an entire administrative team, Mark enrolled and monitored quality and cost data on over 5500 patients during the past 3 years. Mark utilized LEAN concepts such as value stream mapping to optimize processes, reduce patient wait time, and provide the right care at the right time and in the right place. The team developed risk stratification techniques to plan patient care, utilized new billing codes to improve profitability, implemented telehealth to provide care to under-served patients in rural areas, and integrated these new processes into an EMR.

An accomplished operations manager and performance improvement specialist with extensive experience spanning healthcare, manufacturing and service industries. Passionate about continuously improving quality, customer service and value. Exceptional problem solving and motivational skills and the ability to implement sustainable solutions which drive excellence. Self-motivated, articulate, practical, and diligent.