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Hospice Agency Analytics: Best Metrics to Track Staffing Utilization, Productivity and Patient/Family Satisfaction

Hospice Pepper

Is everyone at your hospice agency performing at the top of their game? In today’s competitive market, efficiency and productivity are moving targets. Payors expect you to continually improve your level of care while controlling costs. Meanwhile, patients and their families need compassionate, professional care delivered when they need it most.

Many agencies struggle to manage this delicate balance, and HCHB Analytics (powered by Tableau) can help.

Agency executives are inundated with data – spreadsheets, charts, graphs, and multi-page reports packed with information. Actionable business intelligence is built on metrics, but they have to be presented in a usable format.

That’s where HCHB Analytics’ dashboards excel. Leaders can easily:

  • Use the compare dashboards to compare regions and branches for key metrics.
  • Establish benchmarks and create goals.
  • Study budget goals for each branch and region to keep track of who is hitting their numbers.

Track Agency Progress in Real-time with Weekly Audit Reports

If you review hospice agency analytics to identify strengths and weaknesses, you can correct problems. Unfortunately, the data that leaders receive is often stale. For instance, if you’re just now seeing issues from a month ago, how much worse is the problem now?

Keep your finger on the pulse of your agency with HCHB’s Hospice Weekly Agency Audit Report (WAAR). It presents a snapshot of your agency’s operations that highlights key performance indicators, including:

  • Referral conversion percentages
  • Revenue per day totals
  • Gross margin percentage
  • Visits last week percentages, including missed visits
  • Length of stay totals

The metrics’ color-coding is linked to budget goals. It quickly highlights areas where you’re doing well and those that need attention.

Easy Monitoring of Pepper Target Areas

Close attention to your hospice PEPPER reports can help you avoid CMS audits, but only 51% of hospices accessed their reports in FY2018. Industry experts warn that auditors may view an agency’s failure to review PEPPER reports in a negative light:

“If someone is under a large-scale audit and the hospice has access to the report but did not retrieve it, the government might say it was known or that they should have known that they had payment vulnerabilities, for example, related to long length-of-stay patients.”

CMS issues these metrics quarterly, but our PEPPER workbook allows you to see how you’re doing on a daily or monthly basis, so you can address issues proactively. The analytics metrics can help you understand why you’re getting specific PEPPER scores, including:

  • Life discharges
  • Routine homecare
  • Continuous homecare and GIP
  • Long LOS & Single Dx
Zero in On Caregiver Optimization & Productivity

Staffing has long been a problem in hospice care, and it’s getting worse. More than 26% of hospice administrators listed staffing has their biggest challenge in 2020. By this year, that number increased to 35%. Part of that increase is COVID-driven; the pandemic put tremendous stress on the entire health care system, but hospices have long struggled with staffing issues.

HCHB Analytics provides two workbooks that help you work through staffing challenges. They can help you optimize caregiver use and track field productivity.

Our Caregiver Optimization workbook analyzes visits made during the past 12 months and provides statistics on non-optimized visits. It tracks utilization by specialty and estimates the extra costs of non-optimized visits during the past year. For example, are your schedulers sending out an RN for visits that an LPN could handle for a lower cost? Pay close attention to these totals and consider how you can schedule staff more efficiently.

While the Caregiver Optimization workbook shows whether you are sending the right person to provide the needed level of care, the Field Productivity workbook tracks the productivity of workers as they travel into the field and interact face-to-face with patients.
Track aggregate measurements for the agency as a whole and for individual clinicians. HCHB measures productivity by the time and/​or points systems and carefully tracks documentation time inside and outside the home, sync timing and success, drive time and visit time.
Monitor Continuity of Care Statistics

Continuity of care is important in all aspects of health care, so we make this report available to all HCHB customers. Brown University’s Toolkit of Instruments to Measure End-of-Life discusses the value of continuity of care to both patient and caregivers:

“A sustained relationship of trust and mutual respect is thought to facilitate patients raising issues, divulging private information, or posing questions that might otherwise go unasked. Sustained relationships are said to be important not only to patients, but also to the clinicians, and to many represent a valued part of medical practice.”

Family caregiver satisfaction also contributes to your agency’s CAHPS scores. Better continuity management can help your agency achieve a higher rating.

The Continuity of Care workbook breaks out the number of caregivers that patients are seeing by job code and provides an overall total by month.


Of course, you want the numbers as low as possible, but you’re also working with possible staff shortages and part-time workers. That means that field productivity metrics and continuity of care goals sometimes conflict. Scheduling is more difficult when continuity is also a goal. Homecare Homebase has an Optimization Consulting team that can help you examine your processes and establish efficiency improvements.

Track Hospice Quality Measurements

Our Hospice Quality workbook helps you track how your agency is doing in nine important outcomes and quality measures. Each measure ties to one of the eight National Quality Forum-endorsed measures and one non-NQF-endorsed measure. It also includes metrics like treatment preferences, beliefs/​values addressed, and composite measures.

You can drill down to patient details for a particular month or customize the report for date, agency, or branch details.

Innovative Solutions That Benefit Your Agency and Patients

Does your hospice agency need more?

With HCHB Analytics, access to your metrics, reports, and dashboards is just the beginning of the conversation. We continue it each month, when your HCHB business manager meets with you to discuss your metrics and any additional needs you have. You have the flexibility to create your own custom reports internally or work with our in-house Analytics Consulting group to discuss how we can help you retrieve the data you need to find a custom solution for your agency.

In addition, HCHB tracks large amounts of data that can be used to take your analytics to the next level. Through our exclusive partnership with Muse Healthcare, we combine over 800 data points collected by our system with Muse’s predictive analytics model to help you predict when a patient is about to decline.

The2021 Hospice technology trends survey found that 20% of respondents listed predictive analytics as a technology investment that can improve care and offer a high level of ROI. Increasingly, many hospice agencies are implementing data management and predictive analytics solutions to improve patient support, make better clinical decisions, and manage resources more efficiently. Analytics and AI-based platforms take objective, real-life patient data that helps care teams provide more proactive treatment for hospice patients.

Our partnership with Muse Healthcare provides a predictive model interface that helps agencies enhance end-of-life care and services for hospice patients and their families. 

Muse offers a machine learning system that helps clinicians identify the best therapeutic options for patients.​“Muse HC examines more than 800 assessment points from visits to identify which hospice patients are more likely to decline in their disease within 7-10 days.” This information helps improve the quality and coordination of care during a patient’s final days.

During a recent Webinar, Hospice Care Game-Changer, participants discussed the results agencies are seeing when using Muse hospice predictive analytics to inform their end-of-life care. KahLee Mohrman, Director of Hospice for Knute Nelson, noted:

“We implemented in November of 2020 and by December our quality scores had already increased by 2-3 percentage points. Since we increased those visits at the end of life, our service intensity visits and revenue doubled. That was phenomenal. We saw the exact same impact the next month, simply because we pulled this program into our day to day life.”

Even for experienced professionals, it can be difficult to predict when a patient is declining. Muse’s predictive analytics data helps the care team anticipate when patients need more care, so the care team can adjust accordingly.

Through our exclusive product partnership with Muse, HCHB customers gain the ability to predict, prepare and provide better care for hospice patients and their families in the last seven to 12 days of life.

Contact us to learn more or schedule an in-depth conversation about what HCHB Analytics and Muse can do for you.