Hospices have seen a shift in their referral mix in the last year and half during the pandemic, with patient streams moving away from institutions and towards physician offices. Adapting to the ways they market, educating and coordinating care with referring partners, as well as building and growing these relationships, has hospices honing focus on time and technology management.

Nearly 70% (68.32%) of hospice, home health and palliative care providers recently surveyed by Hospice News and Axxess reported that they lost relationships with nursing facilities and other referral partners due to pandemic-related effects.

Physician offices have become a more significant engine for hospice referrals as more patients balk at facility-based care out of fear of contracting COVID-19, or being unable to see family and friends due to safety restrictions.

Hospices are navigating through new barriers to traditional hospice referral sources, rethinking their outreach tactics and relationship management methods. Reaching patients further upstream in their illnesses meant honing focus on making timely connections to patients and other providers across the continuum, according to Erika Gaudio, senior vice president of sales at VITAS Healthcare, a subsidiary of Chemed Corp. (NYSE: CHEM).

“We had to get smarter about the way that we’re staffing to provide care and how we’re leveraging telehealth on the sales front,” Guadio said during the Hospice News Elevate conference. “What we’ve all learned during the pandemic is the word ‘time.’ How do we target the right audiences to give patients more time to access care? It means going further upstream and not spending all of our time in the hospital, but also not neglecting the hospital. They still need us. It’s really leveraging technology and being thoughtful about time.”

New physician relationships represented the largest growth opportunity for referral partnerships in 2020 and 2021, according to the Hospice News 2021 Hospice Industry Outlook Report. A little more than 40% of hospice leaders identified physician practices as their greatest opportunity, up from 27% in 2019. For 2020, this outranked other referring settings such as hospital systems and assisted living facilities at 24% and 15%, respectively.

The complexity of referral management represents a significant hurdle. Hospices are walking tightropes to balance existing partnerships while establishing new relationships to make up volume. To achieve this providers are leveraging technology, including electronic health record (EHR) interoperability. This can help facilitate a timely response to referral sources, which is a top priority for physician offices.

However for many, their interoperability capabilities are not yet where they need to be to achieve the best results.

“The connectivity layer in post acute is already complicated, but the more you need technology, the more difficult it is for the technology to connect,” said Laura Montesantos, vice president of product management for Forcura. “You don’t need another challenge, and you don’t need more disruption in order to connect those systems. Interoperability really is an issue. It’s going to take a lot of effort and a lot of collaboration to get everyone moving in a connected fashion in hospice.”

Data is also an important element in supporting hospice growth, according to Guadio. Hospices can leverage evidence-based information to demonstrate their effectiveness and quality of care, said Gaudio, particularly when it comes to patient outcomes and reductions of hospital admissions or emergency department visits.

“Having the data of the individual providers enables you to show them the areas of opportunity in which they can refer earlier [to hospice], whether it’s through your own claims data, perhaps patients that they have referred,” Gaudio said. “It’s being able to tell the story through a patient that they’re familiar with and being able to show that provider with metrics, with facts and with data what that means and how it could help their practice. This is huge for practices, facilities, and hospitals as well.”