Relatively Flat Hospice Index Mask Market Volatility Relatively Flat Hospice Index Mask Market Volatility
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Hospice Admissions Index & Volatility Scores

Relatively Flat Index Mask Market Volatility

What is The Hospice Admissions Index and Volatility Score

Hospice Admissions Index (HAI) measures the relative monthly change in the broad hospice facilities’ admissions. The participating hospices are part of the SMARTMD Palliative CRM Virtual Intake Portal (VIP). To be included in the HAI, a facility must be part of VIP continuously for the entire measurement period.

While the HAI looks at the aggregate change, the Hospice Admissions Volitily Score (HAVS) provides the range of change (between the highest and lowest months) experienced at individual facilities.

Raw HAVS indicates a level of change, not the quality of change. Large HAVS can indicate network-wide or substantial changes among a few facilities. These changes can be pattern growth, shrinkage, or ebbs & flows. HAVS indicate how dynamic the admissions landscape is, not how healthy.

This Release OF HAI and HAVS

Stable Admissions Level

On a broad basis, monthly hospice admissions were level in the first 7-months of 2022.  The overall index range ran from a low of 96 (July) to a high of 105 (March). 

The second quarter of 2022 admissions was slightly lower than the first quarter by 3%. 

But, this broad view masks a more volatile reality in hospice admissions.

Impact of Facility Size

Hospices in our data set include smaller (fewer than 100 admissions/month) and midsized (100+ admissions/month) facilities. Combined, the disproportionate presence of midsize facilities’ relatively stable admissions levels masks changes in smaller facilities.  

Drivers of HAVS

Midsized facility HAVS was 31 vs. 64 for smaller facilities. 

The HAVS in the larger hospices was driven by facilities that were growing admissions substantially, as well as some reducing admissions over the first half of the year. There were clear patterns (growth and shrinkage) among the individual hospice.

Smaller facilities’ volatility resulted from broad monthly swings with no pattern of growth or shrinkage. 

HAI: Smaller vs. Larger Facilities

The HAI changes of smaller and larger facilities moved in opposite directions in four of the first seven months of 2022 (5 if we include June, which was near flat for both.) 

Smaller hospice facilities experienced a proportionately wider swing in admission than larger facilities. The broader range of index scores for smaller facilities indicates their vulnerability to the volatility in admissions but doesn’t expose the real changes experienced by the hospices. 

Hospice Admissions Index by Size
Smaller Larger Total
1/31/2022 91 105 103
2/28/2022 106 97 98
3/31/2022 99 106 105
4/30/2022 97 95 95
5/31/2022 101 100 100
6/30/2022 99 102 101
7/31/2022 108 95 96

The relatively stable HAI for smaller facilities masks the market dynamics exposed by the HAVS discussed previously.

Segmenting Hospice Facilities

Segmenting facilities for analysis is important to understanding the hospice landscape. 

Larger facilities serve more populous and usually economically advantaged areas, lending to more stable metrics. Because of the higher density, patients can potentially be served by more than one facility, reducing the risk a single hospice failure poses to the community.

As the hospice industry expands geographically to serve new areas, it does so with smaller facilities and less or no redundancy. These at-risk geographies include rural communities and poor populations within higher-density areas. A single hospice failure can leave underserved communities with no hospice options.

As our data set grows, and we can provide more defined analysis without exposing sensitive information(either directly or by deduction), we will release the HAI & HAVS with geographic views. 

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