Lessen regulatory burden while maximizing person-centered care.

By Gwen Cooper

The 2018 Kentucky General Assembly is right around the corner. And while the headlines are already focused on pension and tax reform, there will be continued emphasis placed on healthcare issues important to the Commonwealth.

As one of our states largest nonprofit medical providers delivering advanced illness and end of life care to over 1100 patients and families a day, Hosparus Health continually monitors legislation that will improve the financial and economic health of our state.

Kentucky, like most of the U.S., is experiencing a healthcare worker shortage.

In addition, Hosparus Health leaders engage in community initiatives and workgroups to help shape healthcare policy to lessen the regulatory burden of delivering healthcare while maximizing the opportunities to deliver personcentered care that improves lives. Getting the pension right and finding innovative ways to manage an ever-growing Medicaid budget will allow our state leaders to focus on improving the health of our citizens, ultimately improving our workforce and quality of life.

Improving Kentucky’s Waivers
Throughout 2017 we provided input to the Cabinet to simplify the Kentucky 1915C waivers to best utilize the federal and state funds available to care for the most vulnerable citizens in our state.

In 2017, Hosparus Health cared for over 125 medically fragile waiver eligible children and adults, often providing care free of charge due to an unyielding regulatory system that did not provide clear guidance for reimbursement of specific hospice services provided.

Our hope is the rewrite of the waivers will fix the regulatory loopholes that prohibit proper reimbursement so that eligible patients can get the compassionate and comprehensive end of life care they deserve.

Maintain Certificate of Need
A longstanding goal of Hosparus Health is to maintain the Certificate of Need (CON). The history, strengths and weaknesses of the CON have been discussed in various reports for healthcare in general, as well as specifically for hospice.

Supporters and opponents of CON have major philosophical differences regarding the role of marketplace competition, cost containment and access to a variety of quality services. Operating hospice services in rural communities today is unprofitable and unattractive to for-profit entities, who would prefer to operate in the already saturated, more urban areas of the state.

Without a CON, mission-driven nonprofits, like Hosparus Health, would face increased competition in urban areas, and may be forced to withdraw from some underserved areas, resulting in less access rather than more access. It is our hope that despite continued conversation threatening the discontinuation of the CON, our data will show continued benefits, especially for our rural citizens, in maintaining the CON for the foreseeable future.

Workforce Needs 
Kentucky, like most of the U.S., is experiencing a healthcare worker shortage. To adequately serve a growing population, Kentucky must address the shortage of healthcare professionals by creating and funding programs to build the medical workforce and by providing incentives to retain and attract healthcare professionals and workers to our region.

That is why, Hosparus Health, along with Greater Louisville, Inc. and One Southern Indiana have pre-filed a bill in the Indiana General Assembly to encourage Indiana to join the National Nurse Compact. Kentucky is one of 26 states benefiting from the Nurse Licensure Compact (NLC) and if Indiana joins, Hosparus Health will save thousands of dollars in dual license costs for our nurses who practice in both Kentucky and Indiana.

Other Issues
Hosparus Health launched a telemedicine pilot in November to expand access to physician telehealth services when necessary and appropriate, especially in our more rural areas. Our medical directors are engaged with lawmakers to introduce legislation designed to expand telemedicine service delivery options to patients with a goal of providing care in the least restrictive, most cost efficient and compassionate environment.

Hosparus Health supports building on the Medical Liability Reform legislation passed in 2017 to limit the exposure of healthcare companies and professionals to frivolous lawsuits as well as confidential peer review.

Additionally, we will continue  to work towards establishing the Palliative Care and Quality of Life Interdisciplinary Advisory Council to improve the quality and delivery of patient and family-centered care throughout the Commonwealth.

National Nurse Compact
The Nurse Licensure Compact is a modern licensure solution for the 21st century. As leaders in public protection, State Boards of Nursing developed and adopted the enhanced Nurse Licensure Compact in 2015. The Nurse Licensure Compact allows for nurses to have one multistate license with the ability to practice in all compact states. nursecompact.com

— Gwen Cooper is SVP/Chief External Affairs Officer at Hosparus Health in Louisville, Kentucky.