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Tampa Bay hospitals vie to get into hospice business

Published Dec. 12, 2014

Hillsborough and Pasco counties need more hospice programs to meet demand, state officials say, a declaration that has sent more than a dozen groups scrambling for the rare chance to expand their end-of-life services.

Among the applicants are three Tampa Bay hospital systems, all of which would be making their first moves into the local hospice market.

BayCare Health System proposes teaming up with Suncoast Hospice, which now serves only Pinellas County, to form a new nonprofit hospice program in Hillsborough and Pasco.

Tampa General Hospital and Florida Hospital Tampa, meanwhile, want to partner on a hospice program, also to serve those two counties.

Officials from all three hospitals say their moves are intended to improve continuity of care, an increasing focus in a fragmented industry.

"Hospitals now provide end-of-life care, but it's not necessarily the best or most cost-effective environment," said Tampa General spokesman John Dunn. "By moving into hospice care, we can provide a new model."

Tommy Inzina, chief operating officer at BayCare, gave as an example a patient enrolled in BayCare's home health care program. If that person becomes sick enough for hospice, BayCare would move its equipment out of the home and the hospice would move theirs in, a potential disruption.

The goal of the new nonprofit program with Suncoast is "to try to help make that care be more seamless and more continuous," said Inzina, who becomes BayCare's president next month.

In addition to the hospitals and Suncoast Hospice, Pasco-based Gulfside Hospice wants to expand into Hillsborough. Hospice of Citrus County proposes moving into Hillsborough and Pasco. The other applicants are hospice programs based outside the Tampa Bay area.

Florida's hospice market is highly regulated. The state has to declare a need for services in a particular county based on demographics, then providers submit applications for a long and rigorous review by state officials, who pick the winner. Losing applicants often appeal, drawing out the process.

So far, applicants have filed only their letters of intent. Complete applications aren't due until the end of the month.

That means details are scant on what exactly the proposed new partnerships would look like, including whether local hospitals might convert some of their acute-care beds into hospice facilities. Officials at the competing hospitals said they could not yet describe any financial arrangements.

Hospices have been cutting costs amid what they say are tough financial times due to Medicare cuts and expensive regulatory changes. This past summer, the parent company of Hillsborough's LifePath Hospice eliminated 89 jobs. A month later, it affiliated with HPH Hospice, which serves Pasco, Hernando and Citrus.

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Officials speaking on behalf of the hospitals said getting into the hospice business might not be a financial boon for those reasons. "It's not always about money," Inzina said.

John Mastrojohn, executive vice president and chief operating officer of the National Hospice and Palliative Care Organization, said there are some good models of hospitals, most of which already offer palliative care, getting into hospice. Florida Hospital, for instance, runs a hospice program in Volusia and Flagler counties.

Hospitals have some financial incentives working in their favor, he said. Under the Affordable Care Act, hospitals face financial penalties if they readmit certain patients within 30 days of discharging them. If patients qualify for hospice, they could receive quality care at home rather than ending up back at the hospital in an emergency situation.

"To me, it's such a win-win because it's a way to enhance the continuity of care," Mastrojohn said.

Contact Jodie Tillman at jtillman@tampabay.com or (813) 226-3374. Follow @jtillmantimes.