How Home-Based Care Providers Are Leveraging Palliative Care In Hospital Partnerships

Oftentimes, talks between home health providers and their many referral partners are an exercise in education. For providers offering palliative care, that education usually starts at a 101-level.

Part of that conversation with hospital and health system partners includes convincing case managers that patients will be better suited at home.

“The longer a patient lays in a hospital bed, I’m convinced that it catches on fire,” Choice Health at Home CEO David Jackson said at the Hospice News/Palliative Care News Palliative Care Conference in Tampa, Florida. “Our mission is the pursuit of excellent health care in the home. Our value prop to hospitals when promoting palliative care is, ‘We want to continue these difficult conversations in a less stressful environment.’”


The Tyler, Texas-based Choice Health at Home is a home health, hospice, rehabilitation and home care services provider that operates mainly in Texas, as well as Louisiana and Oklahoma.

Showing value to health systems and hospital partners at the top of the health care ecosystem has been a main focus for Jackson and his staff as they continue to build out the fill care-at-home continuum.

Choice Health at Home is in a position to have those conversations with referral partners and has the bandwidth to make the transition to the home more manageable.


“If you discharge out into our organization, these are the things that will happen,” Jackson explained. “We will strive to integrate a nurse practitioner group that can actually go out and have a controlled conversation for four or five hours with the family. An MSW is going to engage and continue to continue to try to provide additional resources for this complex patient. We want to be an extender and that’s a value prop that we can provide because the systems — in most cases — don’t have the resources to do that part of discharge.”

Once referral partners understand what at-home palliative care can bring to the table and what the comprehensive care plan looks like, doors open, Jackson said.

Another key value prop that palliative care offers is as a bridge in the continuum of care. It’s always patient-specific and when done correctly, meets patients where they are.

“Palliative care is not a one-size-fits-all type of service,” Kaiser Permanente Senior Director of Hospice and Palliative Care Gina Andres said. “But it does meet the needs of patients wherever they’re at in that continuum. We really focus on giving the right care at the right time in the right place.”

Kaiser is one of the largest health systems and medical groups in the country. Its health plans cover over 13 million people across eight states.

Its home-based care network is made up of about 26 agencies, including companies like LHC Group, Bayada Home Health Care and Pavilion Medical Home Care & Staffing.

Some patients will need palliative care services in a traditional setting. Others will use it strictly as a bridge to hospice, Andres said.

However, it can also be used with a more innovative approach in addressing the gaps that exist in the care continuum.

“I think there’ll always be a need for inpatient palliative care,” Andres said. “But if we touch the patient in outpatient palliative care and we’re giving them education and information and support, it prepares them as they go down the line in their serious illness and need care at home.”

It can also be a lifeline for both patients and caregivers who are going through a new and oftentimes confusing process.

“For the caregiver and the patient, palliative care is such a gift,” Andres said. “There are so many patients that are not ready for hospice, either physically or emotionally or for whatever reason. The number one thing we see with patients and families is a lack of caregiver support and a lack of knowledge. There’s nothing like palliative care for these patients because if they don’t have palliative care, they fall through the cracks. And then what happens? They wind up with unnecessary hospital stays.”

Companies featured in this article: