Transforming Healthcare: Hospice in the News, March 2025

In this episode of TCNtalks, Chris Comeaux and Dr. Cordt Kassner, Publisher of Hospice & Palliative Care Today and CEO and Founder of Hospice Analytics, leverage their data and extensive experience to identify key hospice headlines, articles, research, and social media posts that are driving change and transforming end-of-life care and healthcare in America.

They share personal experiences with hospice care, emphasizing the importance of social work and discussing the challenges of healthcare reimbursement. The conversation also touches on MedPAC recommendations, new social media trends, and highlights from recent research articles. 

The hosts explore pressing issues in healthcare, such as workforce challenges, patient demographics, regulatory changes, and the impact of technology.  They address the implications of the aging baby boomer population for healthcare services, the influence of corporate interests on healthcare spending, and the critical role of leadership in navigating these challenges. 

Their discussion underscores the need for innovative solutions and the role of technology in improving care delivery.  It also emphasizes the importance of preparing for upcoming Medicare and home-based care changes.  The episode concludes with a Masters Class from Chris on what leadership is and why it is so needed during these times.  Join us.

Guest: Cordt Kassner, PhD, Publisher of Hospice & Palliative Care Today & CEO and Founder of Hospice Analytics

Host: Chris Comeaux, President / CEO of TCN / TCG

https://www.teleioscn.org/tcntalkspodcast/transforming-healthcare-hospice-in-the-news-march-2025

Teleios Collaborative Network / https://www.teleioscn.org/tcntalkspodcast

Episode Transcript

Melody King (00:01):
Welcome to TCN Talks.
The goal of our podcast is toprovide concise and relevant
information for busy hospice andpalliative care leaders and
staff.
We understand your busyschedules and believe that
brevity signals respect.
And now here's our host, ChrisComeaux.

Chris Comeaux (00:23):
Hello and welcome to TCN Talks.
This is my favorite time of themonth.
I want to welcome Cordt Kassner.
Cordt welcome.

Cordt Kassner (00:30):
Hey, thank you so much for having me.

Chris Comeaux (00:31):
It's great to have you again, and so this is
our top news stories of themonth for the month of March.
So before we jump in, I alwayslike to ask you a question,
Cordt.
I was thinking I love this is aTony Robbins question.
I use this in my coaching.
If you knew you could not fail,what would you do?

Cordt Kassner (00:48):
You know that's a great question.
It's something I've given alittle bit of thought around and
today, honestly, my answer is Iwould revamp not just hospice
but all of health care in theUnited States, with transparency
, to be reimbursed by qualityand to have clear identification
of the best and the worstproviders in every healthcare

(01:13):
service line.
That would be my goal.
What about you?
What would you do, chris, ifyou knew you could not fail?

Chris Comeaux (01:19):
Well, let me respond to your.
I love your could not failresponse and you probably not
have a chance.
Have not had a chance yet.
We just dropped the podcast onWednesday, March 26th I think it
was with T.
R.
Reid who wrote the book TheHealing of America.
Check that out because there'ssome great T.

(01:40):
R.
wisdom in what you, just becauseI love what you said.
So, in answer to your question,back to me, it's kind of what
I'm doing now.
I feel like helping people findtheir cause and purpose, live
cause and purpose, helptransform health care and create
thousands of leaders orcapacitate thousands of leaders
to live their cause and purpose,and I feel like I'm getting a
play in that arena.

(02:01):
I wish I had more resources, Iwish I had more time.
Every day I get to meet andwork with incredible people like
yourself and if God keepsbringing those incredible people
in my life so we can work onthose things together, that's
what I would do.
So I just need to keep doingand maybe what we're doing at a
higher level and even more.

Cordt Kassner (02:22):
That's fantastic.
Yeah, I saw the notice for theTR Reid podcast and I T.
R.
that queued up to listen tothis weekend, so thanks for the
shout out.
free-market

Chris Comeaux (02:30):
Yeah, actually it's cool and we have another
one coming up as well.
So TR is a little bit more whatI would say a little bit more
left leaning in his approach.
So a little bit more ofMedicare for all.
But I love his packaging, whichis calling it AmeriCare, and so
I think the branding is righton point.
There's some key principles andwhat he discovered as he went
throughout the all over theworld actually.

(02:52):
But we have another personwho's a little bit more free
market thinking and I think theVenn diagram of both their
approaches is the answer of whatour country needs.
And just here's a punchlineAdministrative cost of Medicare
3%.
Administrative cost ofinsurance companies 20%.
That 17% delta as a whole iswhy we're one of the top

(03:13):
spenders in the entire world andwe get pretty shitty outcomes.
But we do not get the outcomesthat you would expect for what
we spend in America.
But there's so many pearls inthat podcast, so this one with
Rita Numeroff will be coming outprobably another 60 days.
So those two we're hoping getpart of the national dialogue
and to all our listeners andalso you, court, please pass

(03:35):
that one with TR Reid around.
Hopefully it'll get in theright hands and the right people
and start to influence thepeople that are sitting at the
table, that could actually makea difference in changing what
health care looks like.

Cordt Kassner (03:46):
That sounds great .

Chris Comeaux (03:47):
Well, one thing I do want to create.
Just first off, our thoughtsand prayers with you and your
family.
You've just gone through apersonal circumstance.
Anything that you want to sayabout that.

Cordt Kassner (03:59):
I appreciate the opportunity I've shared with you
and a few others offline thatmy mother recently died under
hospice care and you know thispersonal experience with hospice
highlighted several themes,mostly positive.
I'm early in my reflections andhow to articulate this
experience in ways that I wantto use to strengthen hospice

(04:21):
care and reaffirm the hospicephilosophy of care.
To use to strengthen hospicecare and reaffirm the hospice
philosophy of care.
But even today, as I review topnews stories this month, I'll
share some of those personalreflections.
But I'm just it's.
I've learned a lot by being ason receiving hospice care.
You know, with a family memberreceiving hospice, that that I
did not maybe feel I'm not sureif I didn't know it, but I

(04:45):
didn't feel it the same way thatI have for working in the
hospice field for 25 years.

Chris Comeaux (04:52):
Yeah, you know Tina Gentry on our team.
She always had this amazingtalk she would give and I've yet
to figure out how to put inwords because it's a gesture but
she says most people understandhospice but once you experience
it, most people understandhospice.
But once you experience it, youunderstand hospice.
And I know our listeners don'tknow what I just did.
I pointed to my head understand, but then when you experience

(05:13):
it she would kind of cross herhands across her heart and it's
such a profound way of kind ofputting into a action of what I
think that you're kind of pokingon.
There's just this.
It's so holistic and it impactsus in so many different ways.
How do you put words aroundthat unless you actually
experience it?
So I don't know if you havecomments to that, but if that's

(05:35):
in the ballpark of what you'regetting at.

Cordt Kassner (05:38):
It absolutely is, and I'll circle back to that in
a couple of minutes.

Chris Comeaux (05:42):
All right, perfect.
Well, you want to jump in.
So, with the data Hospice topnews stories of the month, we
want to always continue to giveyou and Joy a shout out for the
great work you're doing withhospice and palliative care
today.
So you want to share the stats.

Cordt Kassner (05:56):
Sure.
Thanks so much and forlisteners.
Dr Joy Berger is oureditor-in-chief of hospice and
Palliative Care Today.
She does an amazing job pullingtogether articles.
We review over 1,200, 1,500articles a day to consolidate

(06:16):
that down to about 15 articlesthat we put into a free daily
email focused on hospice,palliative care and end-of-life
care.
So as we looked at theclick-through rates for hospice
and palliative care today'sMarch news stories, we published
a total of 361 articles thatcollectively received 137,000
clicks or reads.
Notably, 32 of these storiessurpassed 1,000 clicks each.

(06:39):
All of these metrics surpassedFebruary's numbers, which
surpassed January's numbers.
So let's take a closer look atthe key trends.
The most read story was SocialMedia Toolkit for Social Workers
Month 2025.
And I want to extend my thanks,my gratitude, to every hospice

(07:00):
and palliative care socialworker out there, not just
during the month of March asSocial Workers Month, but every
month.
I've mentioned before myundergraduate degrees in social
work and once a social worker,always a social worker.
It's appropriate to lead thismonth's story by the National
Association of Social Work, theNASW, with follow-on stories

(07:25):
from hospices and how they haveboth integrated and appreciated
social workers into their care.
This year's theme from NASW issocial work, compassion plus
action, which I thought wasentirely consistent, chris, with
the discussions we've had ontop news stories so far this
year.

(07:45):
Joy ran the second most readstory this month on Ash
Wednesday, which was titled whatDo the Ashes Symbolize in Life,
death and Cultural Rituals?
This is perhaps the highestread article we've had from a
spiritual or religiousperspective.
So here we're starting outMarch with social work and

(08:07):
spiritual care, which I think istremendous.
This article explored themesassociated with ashes, such as
loss and renewal, culturalpractices involving ashes in
different religions, and more.
Our third most read article wasactually an internal note we
distributed about systemupgrades that we've made to the

(08:30):
newsletter.
I'll mention that we've refinedour search engine, so if you
log into your subscriptionaccount now, there's a search
bar that pops up and you cansearch all of the content we've
ever run, so you can search fornames or topics or themes.
While logged in, you can alsogo in and look at our newsletter
archive, where we've postedevery past newsletter issue, so

(08:53):
a tremendous resource for oursubscribers.
However, as we were doing someof that, we heard from some of
our readers including you, chris, which we really appreciate
that newsletters were not beingreceived.
So part of our system upgradenote was to please let us know,
please let Joy or me know if youhave any trouble receiving
newsletters.

(09:14):
We work with Infront Webworks,our web hosting company, to
resolve these issues quickly.

Chris Comeaux (09:19):
Yeah, I just want to give you guys a shout out
and I think that's a good sign,right?
People are calling you sayingwait a minute, where's my
newsletter?
So that means it's.
Yeah, I know, for me it'sbecome part of my daily habit,
it's my early morning ritual togo through, and just kudos for
you guys.
I mean, we're living at apretty interesting time.
You and I talked about that inlast month's top news stories of
how quickly with artificialintelligence, things are moving,

(09:40):
so to kind of stay on theleading edge and refining your
search engine.
I just want to give you a tipof the hat for you enjoy both.
That keeps you really on thecutting edge for all of your
readers and I think it's a greatsign that people are like, hey
man, where is it at?
And then we figured out on ourside that you know the beginning
it was related to your upgrade.
The second part is I was tryingto be on the leading edge.

(10:01):
I installed an artificialintelligence tool on top of my
email and it was actuallyfiltering your newsletter out.
So we learned.
So we're both trying to stay onthe leading edge.
Sometimes there is going to bea couple of issues related to
that.
But that's all part of theadvancement of growing and
learning and kind of changemanagement.

Cordt Kassner (10:18):
Well, we've always found that I have used
the phrase and it doesn't reallymatter the topic.
Putting out a daily emailnewsletter is easy.
Hospice care is easy.
Building a robot is easyCommunication is hard and just
the back and forth, theinterpersonal, the communication

(10:39):
, letting people know is reallythe President hardest part,
because we can figure out therest of it.

Chris Comeaux (10:46):
Well, you know, I was actually thinking too when
you were talking Court, aboutjust the genesis of this
newsletter.
You know your predecessor yougot this from Mark Cohen and,
thinking about Mark's history,he literally would wake up every
day, scour articles and walkinto President Carter's office
and say, president Carter, thisis what you need to know about
today's news, which isfascinating if you think about

(11:07):
that.
And then to take that laterinto the realm of hospice and
palliative care, and now howyou've moved that forward.
You enjoy both and your uniqueskill set, but then also
incorporating technology withinthat.
I really feel like you've uppedthe game of what originally
started as maybe a superpower ofMark's, but you guys have kind
of melded into a whole newsuperpower and how you've also

(11:27):
melded technology with it.

Cordt Kassner (11:29):
It's been interesting and I've got another
tech comment coming up in aminute that you in particular,
but I think all of oursubscribers are going to be
interested in.
In addition to these firstcouple of stories, another story
that came up with a lot ofclicks was a story honoring
National Vietnam War VeteransDay and another story on

(11:53):
end-of-life care patterns amongbeneficiaries with cancer that
each had NPHI 3,000 reads.
There were a couple morestories on MedPAC's recent
report to Congress, which isreleased every March, and I
personally really appreciate thework of Kim Newman and the
MedPAC Commission every year.
It's a monumental task and Ithink they do a great job.

(12:16):
I find their work consistentwith promoting the hospice
philosophy of care by focusingon utilization trends and
quality reporting.
They also detail financialaspects of hospice, examining
profit margins and potentiallyfraudulent areas.
Of course, most folks areinterested in MedPAC's
recommendation to Congressregarding hospice reimbursement

(12:39):
for the upcoming year.
This year they recommended noincrease or decrease in hospice
reimbursement.
That's somewhat based onaggregate profit margins that
they've calculated for hospicesacross the country.
Congress weighs MedPACrecommendations heavily,
although it's important to notethat Congress's decisions are

(13:02):
based on a different set ofpolitical priorities.

Chris Comeaux (13:04):
Congress's decisions are based on a
different set of politicalpriorities.
Yeah, I'd like to make acomment on that.
One, cord, is that I have great, immense respect for Kim.
I've heard her come and speakat MPHI another group, super
competent person and get kind oftheir process.
But something that Dr Thayer, mymentor, always said is he
called it the tyranny of theaverage, and that quite often
people make decisions based uponkind of average numbers, and I

(13:28):
think there's some wisdom inthat.
In this case, like you know,the average of the margin being
at whatever it is 12 percent, 10, 11 percent.
The distribution of that,though, shows the nonprofits are
more of like one percent ornegative percent, and the for
profits 20 percent plus ornegative percent, and the
for-profits 20% plus.
And you may you know if someonejust looks at those numbers and

(13:49):
go well, obviously they must besuper competent, nonprofits or
not.
No, it's the devils in thedetails of.
You know what does the actualmodel of how the care is being
provided?
The Japanese have a wonderfulterm called gimbal walk.
Go see for yourself.
I realize MedPAC can't go in ahospice visit, but if you start
going to that zero in at amicroscopic level, there's a

(14:10):
whole lot of details in therethat dictates what that average,
the tyranny of the average, is.
And so you know, I know what Isee in these nonprofits doing
incredible work, doing leadingedge things like powder care,
which loses money, pediatricprograms et cetera.
And yes, they could fundraisefor some of those things, but
they don't have enoughfundraising to cover all of
those losses.

(14:30):
Plus, they have a much richerstaffed model to patients which
means they get more care by thebedside.
We now have data backing thatup Cap scores visits in the SIA
in the last days of life.
Nonprofits do a lot betterthere.
So because of that they have ahigher cost model, which is why
the margins are what they are.

(14:50):
But they're doing the rightthing.
They're trying to provide amore robust model and you don't
see that in those averages.
And oh, by the way, we're livingat probably one of the most
inflationary periods I know inmy career 30 years in hospice.
So wage pressure super high,the revenue rate is not even
coming close and this isbasically saying, hey, keep it
the same.
And those inflationarypressures are only increasing.

(15:12):
We have a lot of people talkingnow about the tariff situation.
Is it going to drive up drugcosts, medical supply costs, so
all the patient related as well.
I'm an accountant.
The math don't work if then therevenue is not increasing, and
those expenses are increasingquite a bit.
So I'd like to be a little bitmore sophisticated instead of
you mat back people.

(15:32):
You're not giving us a raise.
What's wrong with you?
I get their perspective, butI'd like to provide a little bit
more intelligent perspective ofwhy I don't think that's a good
decision.
You have to look within thedetails, and there's a
differentiation between thefor-profits and the non-profits.
So could we come up withsomething that's a little bit
more equitable, based upon therobust model of care that people

(15:52):
are providing?
Maybe hope is starting tolaying the tracks for that, et
cetera, et cetera.
So I'll get off my soapbox.

Cordt Kassner (15:59):
No, it's fascinating.
And to the earlier point, oneof the things I appreciate about
Kim and MedPAC is, if you wantto meet with them, set up a
meeting with them.
If that's NPHI, if that's anygroup, if that's an individual,
they are open to thatcommunication.
And it's where they come upwith ideas like the U-shaped

(16:20):
curve that turned into higherreimbursement for the first 60
days and the very end of lifecare, lower reimbursement in the
middle, because they're tryingto work with some of those
discrepancies that you point out.

Chris Comeaux (16:34):
That's a great point.
You know what, put your moneywhere your mouth is, and so I'm
going to take that as a goodchallenge.

Cordt Kassner (16:41):
Tell her hello for me.
Another area I'd like tocomment on that had surprisingly
high number of reads is a newcategory we just developed
called Social Media Watch, andthe background for this story is
a conversation between Joy andour friend, judy Lund-Person.
They were talking about severaldifferent topics and Judy

(17:02):
mentioned how often interestinginformation is posted on
LinkedIn and Joy and I took thatto heart.
We started talking about that.
I'm like, well, we don't coverthat and I don't know that
anybody necessarily covers that.
Social media watch, where Joyand I are reviewing our own

(17:23):
personal LinkedIn accounts forinformation that Hospice and
Palliative Care Today readersmight be interested in.
This became one of our topposts this month, in addition to
Joy and my own LinkedInnetworks.
We just set up a Hospice andPalliative Care Today LinkedIn
business business page and soplease find that, follow us,

(17:47):
invite us to follow your pages,because that's going to become
the source for our social mediawatch posts and judy was
absolutely right a lot ofinteresting information there.
We don't.
We created that new categorybecause we're not in the
business of fact checking all ofthis stuff.
We're in the business ofsharing what's out there love it

(18:09):
, hate it, you know right, wrongand we we use discretion with
it, but it's just anotherfascinating area to to take a
look at.
We released the second socialmedia watch in today's
newsletter.

Chris Comeaux (18:23):
Yep, which had a really big one actually.
So, um, kudos, kudos to youguys for doing that.
I think that's brilliant andjust love Judy that she brought
that up to you.
I'm just so blessed with the.
We're able to work around suchamazing, brilliant people like
you enjoy and she and manyothers.
So major kudos on that.

Cordt Kassner (18:39):
Thank you, that's very cool.
Uh, another article I'd like tocomment on that had about 500
reads Cordt which is not a lot,necessarily in the way that
we're tracking all of thisinformation.
The title of the story is ADoctor's Tumor Rupture Upends
All that she Knew.
This is one of many fascinatingarticles that explore how

(19:00):
humbling and transformative itis when the doctor becomes the
patient, and this articleincludes an example of a woman
physician who's pregnant, who'snow the patient, teaching a
young physician how to read herown ultrasound, which tragically

(19:21):
found that her baby no longerhad a heartbeat.
So she's the doctor and thepatient at the same time.
It goes on www.

(20:14):
nationalhospicelocator.
com to discuss how being apatient changes this physician's
practice.
Kathy Wagner, who helps us withour Saturday research issues,
brought this article to myattention and said Cord, this is
an article that I wish everyphysician, every nurse, every
healthcare person I come incontact with should read.
And it leads me to a real,quick story about my own
experience with mom being in ahospice the hospital.
Mom was in the hospital beforeshe transferred into hospice.
The hospital social workercalled me and said your dad
tells me you have an opinionabout which hospice we should
contact for your mother.
I was driving at the time so Isaid well, yes, I do.
Are you in front of a computer?
Could you go towwwnationalhospicelocatorcom?
She typed it in and she typedin the city.
She found 20 hospices servethat city and I said I want one
of the first three.
And she kind of paused and shesaid well, that's interesting.
What is this website?
And I said well, it ranks everyhospice in the country based on

(20:38):
the quality metrics and sortsthem from highest to lowest.
She thought that was reallyinteresting, right until I
commented that this was mywebsite, that I built this with
input from hospice leadersaround the country and it's one
of the many practical thingsthat hospice analytics does to
drive patients to high-qualityhospice.
Later, mom needed GIP level ofhospice care.

(20:59):
She wanted to stay in thehospital that she was in, and so
the social worker said we don'tcontract with 20 hospices, we
contract with two.
So that limited my hospicechoice.
And then she went on to say oneof those two hospices is not
currently staffed to provide GIP.

(21:19):
So I now had the choice of onehospice or no hospice at all,
and fortunately this hospice isa good provider and they took
good care of mom, but I foundmyself thinking hospice choice I
have 20 and I don't.
My choice was actually based oncontracting, not the quality

(21:41):
rankings that I'd spent so muchtime developing, and so it gave
me a different angle on theimportance for hospices of who
they're contracting with andwhat patient base that allows
them to serve.

Chris Comeaux (21:55):
That's interesting.

Cordt Kassner (21:58):
I like highlighting, every year or
every month, some of the mostread research articles.
In March, a lot of our top readresearch articles focused on
different aspects of cancertreatment.
There was also a couple ofatypical research articles with
hundreds of reads, one of themon experiences of medical

(22:18):
interpreters' experiences withpatients who are near the end of
life and Cordt one exploringdisparities in end-of-life
symptom burden linked to patientwealth, health and social
support, which I thought wasfascinating.
Chris, what did you find?
What were your top stories thismonth?

Chris Comeaux (22:39):
Yep, before I go there, I've got my paper here of
my summary, but also I thinkmaybe it's been two months now,
but we're now taking your data,which is awesome of like the
quantitative data feed thatyou've been providing, so we're
providing that summary.
So, please know, if we juststep back for a second, just
think of what Kurt said.
He and Joy go through thousandsof articles daily, get it down

(23:03):
to 15.
These are 15 things that youneed to know, and then what I
try to do is I read that everyday and then my perspective is
as a C-suite leader, these arethe ones that I hope that you
didn't miss.
So this month I flagged 53,which it's interesting.
I think you guys are gettingbetter and better and better.
So it's making me be even moreselective, because I was

(23:25):
generally running at about 90 toa hundred, but I've now found
so I think it's about 50something.
I think part of that is youguys are definitely getting good
what you do as far as the data,so I'm able to be even more
selective of like this is what Ihope you didn't miss as a
C-suite leader.
I think there's something elsegoing on, but I think you'll

(23:46):
probably poke me on that at theend that I'll kind of make a
comment.
So let's go into it.
So at a big picture level.
So I always have my 10categories.
The two biggest this month werereimbursement challenges at 12
articles, and then patient,family, customer demographics
and trends, which was actuallyat 11.
My third biggest category,which is where I'll camp at the

(24:08):
end, is just kind of Chris'scategory, the ones that kind of
my catch all.
Hey, this is the stuff I hopethat you didn't miss.
So let me go into it.
So the first category is alwaysmission moments Only had three
articles this month.
They were really three profound.
I'm not going to spend time onthem Again.
This is why I also provide thesummary that I have in my hot
little hands here, a picture ofit you guys could download.

(24:30):
That again is kind of inservice to you.
So the next category isreimbursement.
This is one of my highest.
This month.
We had 12 articles.
There's six I just want to bringyour attention to in this
podcast.
The first one is Medicaid.
Health plans are failing to payhospices for nursing home room

(24:50):
and board, ding, ding.
Make sure you're aware of thatas you're seeing more and more
MA plans or just MA companies orinsurance companies that are
managing Medicaid.
They ain't paying nursing homeroom and board and that's
raising some interestingchallenges from a cash flow
perspective of serving thosepatients in the nursing home.
The next one as we know, thiswas a big deal in the whole
budget standoff but Congresspassed a telehealth and also a

(25:12):
hospital at home that was intheir funding bill in the budget
that eventually did pass.
So just want to make sure youdidn't miss that, the budget
that eventually did pass.
So just want to make sure youdidn't miss that.
Another one MedPAC recommendsCongress tie physician pay to
inflation for 2026.
A lot of the programs we workwith have robust palliative care
programs that some need to know.
That you want to make sure youdidn't miss.

(25:32):
And then the other that quarteralready kind of brought your
attention.
The MedPAC 2025 annual reportwas released, basically
recommending that we don't getany pay raise going to future
years here.

Cordt Kassner (25:46):
You know, I think TCN Talk going to Dragonfly up
spending a pretty fair amount oftime talking about MedPAC and
their recommendations and howthey see the hospice field.
I'll keep comments short fornow, but I would recommend all
of our listeners that thereading the MedPAC report is
right up there with reading thehospice final rule.

(26:07):
We talk about it and very fewof us actually do it, but it's
worth the time for the read.
Dragonfly

Jeff Haffner / Dragonfly (26:15):
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Dragonfly Health is also thetitle sponsor for Leadership
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Dragonfly Health uses advancedtechnology and robust analytics

(26:38):
to manage durable medicalequipment and pharmaceutical
services as part of a single,efficient solution for
caregivers, patients and theirfamilies.
The company serves millions ofpatients annually across all 50
states.
Thank you, dragonfly Health,for all the great work that you
do.

Chris Comeaux (27:02):
Yep, Usually what I do is I'll print it out and I
take it to bed and try to go tobed a little early and it's dry
, tough reading, but it'ssomething about that.
So the ritual a couple of timesa year, as you said.
The wage index and this one,those are two of mine and I
usually do sleep fairly wellthat night, but it's kind of how

(27:22):
I get it done All right.
So, continuing in that category.
Cms deletes Medicare Advantagevision statement, signaling
another shift from health equity.
So that's an interesting, maybea little bit of a little
blinking light on the dashboard.
A little blinking light on thedashboard.

(27:43):
Another article MedicareAdvantage special need plans are
linked to use of inferiorhospice care, which is actually
more of an opportunity than arisk.
If you read that article.

Cordt Kassner (27:51):
Yeah, you know, I'd chime in with that one.
I think the Medicare Advantageplans right up there with
private equity ownership ofhospice and some of those
ownership trends are reallygoing to be something to keep an
eye on this year.

Chris Comeaux (28:02):
Yeah, I agree with you.
I think I mentioned one of ourboard members.
I love his phrase it's going tobe a predictably unpredictable
year and I think you're right onpoint that that's going to be
an area to watch.
All right, so I'm going toshift to another category.
The next is competition to beaware of.
There were four articles, in mysummary only two I wanted to
bring to your attention on thepodcast, how Houston Methodist

(28:24):
ACO reduced its end of lifespending by 20%.
Once you dig into that article,it cites Coda Health, which is
interesting.
It's like a digital platformthat provides advanced
directives.
Might be a really interestingopportunity for many of our
hospice and palliative carelisteners to go.
We can do that.
We've got a superpower in thatarea.
Another one, a big one thismonth Walgreens sells to private

(28:49):
equity firm Sycamore Partners.
I don't know about you, cord,but I've seen Walgreens go
downhill majorly in ourcommunity, walking in like eight
o'clock at night, try to getjust something and they barely
have anybody in the store andthen just the employees not
being very happy and kind ofarticulating that.
So it's going to be reallyinteresting to see what happens

(29:09):
as private equity takes overWalgreens.

Cordt Kassner (29:12):
Well, and Walgreens used to be such known
as the community, the store onthe corner, and I'm seeing left
and right Walgreens locationsshutting down, being closed, and
I can't help but think that itmight be related to the private
equity, the financial aspect ofneeding to show a certain margin
to keep the doors open.

Chris Comeaux (29:32):
And, if you remember, in Jim Collins' book
Good to Great, it was actuallyone of the companies that was
highlighted and kind of theposter child for the definition
of the hedgehog concept.
And so maybe differentconversation for a different day
, all right.
Next category is workforcechallenges, and so four articles
in this one.
A little bit of a rabbit trail.
We have a really interestingthing going on within our TCN

(29:54):
network, we call Future Councils.
You're actually participatingin one of them and this is a big
one.
Workforce challenges, and sofour articles.
I want to actually highlightall four.
First one Willow Point NursingCenter this is in New York state
raises pay by 20% for all ofits staff.
Interesting, interesting thingthis is under the implications

(30:15):
of the workforce challenge, alsounder implications from heroes
to burnout how we failed ourfrontline healthcare workers.
This was a med page.
Of all the lessons learned fromfighting a pandemic, none was
more frightening or importantthan discovering how dependent
our whole healthcare system ison how we treat our doctors, our

(30:36):
nurses and our frontlinecaregivers.
They were already in shortsupply, but with burnout on the
rise, and then the pandemic hit.
And now frontline caregivers.
They were already in shortsupply, but with burnout on the
rise and then the pandemic hitand now we have a full-blown
kind of crisis on our hands and,unfortunately, as the silver
tsunami wave hits the shore ofhealthcare, which I've got a
couple of articles that I'mgoing to cite related to that as
we go forward.
So I thought that was a reallyinteresting article.

(30:56):
Paints the picture of theimplications.
Always, love the solutions andagain, kudos to you and Joy,
because I feel like you're.
You're mining more and moresolutions and I appreciate that
our future council team isactually looking for those type
of articles.
So, under solutions, the risingimportance of social workers on
the home health team, how somepeople are like, well, we've

(31:17):
figured that out already, but inan interesting as kind of home
health has gone through OASISand all these reimbursement
challenges.
They're kind of coming backfull circle and graphing in
other disciplines.
I think that's the principle inthe learning lesson as we go
forward, you may go.
Well, we got social workersalready.
What about paramedics?
What about community healthworkers?

(31:38):
What about other disciplinesthat may be absolutely necessary
for us to deal with the mathproblem of demand for our
services versus workers that wehave.
How work in the hospice fielddiffers from hospital work Love
that.
That was in healthcare businesstoday.
I know my hospice people arelike, yeah, we know that.
Are we advertising that whenyou're advertising for why, you

(32:01):
know?
I think we are the oasis forhealthcare.
How well do we market that whenwe put out advertisements for
job openings that we have, etcetera?
So those are my workforce.
I love that category everymonth.
The next one is patient familydemographic trends.
This is always a big one andyou guys do a great job.
So I actually had 11 articlesthis month.

(32:21):
I'm going to cite eight of themreal quick.
Hospitals may buckle under thetsunami of patients.
That was in modern healthcare.
There's another one related tothat that I'll get to in a
couple moments.
This was in 50 plus finance howmuch does end of life care
generally cost?
Which is really cool.
It's talking about the generalcost of healthcare and actually

(32:42):
having hospice care graphed in.
There is a way to kind of getan economical value for your
money at end of life care.
So that was a really coolarticle.
Becker's 748 hospitals are atrisk for closure and then they
have like a state by state grid.
That was a really big article.
Wasn't clicked on very much byfolks.
Mark Cohen used to always saywhen the hospital catches cold,

(33:04):
does hospice catch pneumonia?
I never fully agreed with himwith that.
Another way I'd say it ishospitals are a huge part of the
healthcare ecosystem in yourcommunity.
That ecosystem gets disrupted.
What does that mean for us?
There's crisis and opportunity,probably in both sides of that
equation.
Certainly a great opportunity,maybe to get staff, as we talked

(33:26):
about a little bit earlier.
This one I found and kudos toyou guys for flagging this one,
I thought at a personal levelthe weekend effect.
If you're planning surgery,doctors say you should think
twice about Fridays.
That was fascinating.
But as you and I do this work,I've noticed weird trends in
like number of articles.
Like around Christmas, right,there's a lot of people off and

(33:49):
so whoever would have thought,oh my God, I'm getting surgery
on Friday, am I going to getlike subpar care?
But there was a great data inthat actual article related to
that.
Another one understanding andaddressing the hospital bed
shortage.
Kind of taking a phrase fromTrump instead of drill, baby,
drill, it's build, baby build.

(34:10):
Now, the reason I wanted tocite this was actually in JAMA.
So, understanding andaddressing the hospital bed
shortage, I wonder as we goforward as care shifts into the
home.
So let's say I just take thatat face value.
Man, the construction companiesare like, yeah, baby, that's
awesome, we'd love to see youbuild baby Bill.
Just in Nashville, northCarolina, there was a $500

(34:33):
million construction projectbuilding new hospital beds
replacing old facilities.
But I wonder the ROIcalculation on that.
As the baby boomers crash onshore, what if that wave tilts
to the side of care in the homeas opposed to care in the acute
care facility?
It's going to be reallyinteresting to see how that
plays out into the future.

(34:54):
And then here.
So here's a couple more.
This was at McKnight's Lesswealth at death linked to more
end-of-life symptoms, and reallyinteresting about wealth
disparities and end-of-lifesymptom burden among older
adults.
There's some great data in thatarticle that to me, bears on
the future.
American Journal of ManagedCare More care doesn't equal

(35:17):
happier patients in traditionalMedicare.
Again, to me that's kind of atip at the hat of the work that
we do.
It's always paradoxical thatpatients die in hospice, but yet
we have really goodsatisfaction.
And then the last one in thiscategory.
Again, kudos for highlightingthis.
But this is the type of stuffthat I think will help with the
cultural shift about end-of-lifecare, but Bradley Cooper has a

(35:39):
film on caregiving to preparepremiere on PBS for nationwide
broadcast this summer in June2024.
The streaming begins on May27th and that's something that,
something I think you and I willprobably highlight as we go
into this year.
I've thought long and hard abouthow do we, how do you
counteract, like the whole HBOseries I'm mentally blanking on

(36:01):
the guy's name and I'm going tokeep blanking on his name
because I don't want to say itout loud, but like, how do you
counteract that?
And it's like I think it'sdocumentary series, movies I've
always envisioned, like wouldn'tit be awesome to have a reality
TV show of just a beautifulmission moments within hospice,
those things that we highlighteach month in here?
All right, so, moving onregulatory, we had three

(36:25):
articles this month.
Only one that I wanted to kindof call out, which is CMS will
not resume implementation of thehospice SFP in 2025.
So they're going on record.
They're not going to redo itthis year.

Cordt Kassner (36:37):
I thought that was really Judi interesting.
And again it gets back to thattransparency and we talk about
wanting to root out waste, fraudand abuse until somebody
actually puts names on a pieceof paper and then there's a is
trying to bring thattransparency, even though it's
knowing that that's an unpopularthing to do.
I think that the bigger picturephilosophy there is actually

(37:12):
very helpful.
So I'm keeping an eye on thespecial focus program and how
they're going to continuerefining their methodology and
how this kind of plays out goingto continue refining their
methodology and how this kind ofplays out.

Chris Comeaux (37:25):
Well, if our friend Judy was here, the first
thing she'd say is okay, 50% ofhospices have a satisfaction
survey.
If you were on Amazon, you andI probably both stay away.
Well, this one doesn't have anyreviews yet, so I'm going to go
with the product that hasreviews.
But I don't think most peopleknow that 50% of the hospices
don't have satisfaction.
So maybe here's a simple thing.
Well, and the hospices don'thave satisfaction, so maybe
here's a simple thing If, well,you know, you can't do a

(37:47):
satisfaction survey because theN is so small, well, you know
what?
If you got less than 40patients, you're not a viable
operation anyway.
So you got 18 months to becomeviable, otherwise the typical
market would punish you anyway,and after that you should have a
satisfaction survey, maybesomething as simple as that.
Now we got 85% of hospices inAmerica that you do have surveys
.
Now we can't have that.
Well, this is why SFP is wrongis because 50% of the people

(38:09):
aren't even getting covered inthis because they don't have a
satisfaction survey.

Cordt Kassner (38:13):
I could certainly support a few questions,
quality-oriented questions, thatevery hospice, every
Medicare-certified hospice, hasto participate in.

Chris Comeaux (38:25):
Yep, okay.
So technology is my nextcategory.
I had four articles, only threeI want to cite in here.
I love this one this was in CIOthe eight new rules of IT
leadership and what they replace, and I love how it kind of like
old rule serve the business.
New rule lead together with thebusiness.
New rule lead together with thebusiness.
Old rule train workers on newtechnologies.

(38:46):
New rule help workers becometech fluent.
That's a big one.
Old rule businesstransformation comes first.
New rule IT leads by example,which is kind of interesting.
Like does that mean the tail'sgoing to start wagging the dog?
And I think that's going to bepossibly what you're going to
see as AI gains more and morekind of momentum.
Old rule IT folks stay in yourlane.

(39:09):
New rule collaborate across theenterprise.
So that was just an awesomearticle.
Very few, I think that had like"Can I don't know, it was
definitely less than 100 clickson that.
One hundred clicks on that one.
Next one hallucinogenins.
You know those drugs likepsilocybin and ketamine may
elevate death risk by more thantwofold.

(39:30):
That was in Medscape.
And then also kudos to Meg andher podcast with Hush Blackwell.
They highlighted it.
We have one in the can.
That's already done, that'sslated to come out this summer,
with one of the top physicianson the use of ketamine in
hospice end-of-life care.
This one concerned me becauseit was just more about the
negative, because it elevatesdeath risk.
There's no doubt you have to becompetent, you have to know

(39:52):
what you're doing, but I don'tthink the answer is totally stay
away from it, and so that'sactually why we have a podcast
coming out this summer on theuse of ketamine in hospice.
And just last technology one AIscribes Can technology do more
than free doctors from the dataentry?
I think there's a lot of coolstuff we're going to see about
the application of AI.

(40:13):
We actually have one that ourTCN network has been piloting,
where the nurses speak, the AIgrabs it, puts it right in the
medical record, and so thatwhich could really save our
clinicians time at a time whenthey don't feel like they have
enough time.
So last couple categories speedof change, resiliency and
reculture.
I had two articles only one Iwanted to cite Our good friend

(40:35):
Lynn Flanagan, the CEO of Ancora, which is a TCM member, and
Tina Gentry, our chief operatingofficer.
They did an amazing articlecalled Leadership with Grit,
grace and a Bold Heart.
That is an awesome read.
If you've not seen that, pleasecheck it out, and kudos to
Court and Joy for actuallyhighlighting it.

Cordt Kassner (40:53):
Yeah, I'd give a shout out for that one too.
They did an amazing job, and ifyou haven't read that article,
do look it up.

Chris Comeaux (41:02):
A little brain tattoo from that article, do
look it up.
A little brain tattoo from thatarticle.
A soft front, strong back.
And Talks so quite often, youknow I've been blessed, I'm
surrounded by amazing femaleleaders, and the answer is don't
become more like a male, infact of anything.
Brene feel like that's maybepart of the problem with our,
I'll say industry.
I know Mark Cohen will kind ofget twitchy, but in this term
I'll say industry becausethere's more males and I go to

(41:22):
certain conferences and it lookslike a Wall Street banker type
conference.
We've lost something in thatprocess and so be bold, as
females have created this wholemovement, this field.
I'll now reframe it that waybecause it is a movement and
field when it's coming from thatsoft front, strong back type
standpoint.

(41:42):
And maybe the nuns, that's whatthey're after, with no margin,
no mission, but it's also notall margin.
Forget the mission.
It's the both together.
All right, human factors.
Cordt, so one only one article,and I just want to cite it, but
it was really.
Kudos to you.
Five must watch TED talks.
That will make you a betterleader.

(42:03):
Right now, a Simon Sinek, aDaniel Pink who's actually
coming up on our podcast, sostoked about that one, brene
Brown and Ken Robinson, and thenalso Luva Aja Jones, and so
just three great TED Talks thatare like action packeded, like
full-day leadership lessons andlike 20-minute videos.
So that was an awesome call out.

(42:24):
All right, my last category.
These are the ones I want tocamp out on a little bit.
So I actually had nine articlesthis month, eight that I want
to cite, and you feel free tokind of challenge me or ask
questions on any of these.
Court.
So shareholder payouts amonglarge publicly traded healthcare
companies.
There's a growing concern thata large proportion of US health
care spending appears to bedirected to corporate

(42:47):
shareholders rather thanenhancing affordable access.
In other words, they'reforgetting about the mission of
what they're here to do.
That was actually a JAMAarticle, so just want to cite
that.
I think a lot of people thought, oh, you know Trump's
pro-business, and so they'rejust going to go whole hog.
Private equity, just you know,drill, baby drill.

(43:11):
Private equity, baby privateequity.
I don't think that's the caseand I've actually seen some
really good, at leasthighlighting and talking about.
It'd be interesting to see iftalk does cook rice, if they
actually do something about it.
Another really interesting oneBeata Home Health introduces
their first director of VeteransAffairs.
That is brilliant.
If I had a great budget andkudos to them because they're a

(43:32):
large organization what abrilliant way to put resources.
To think how do we better servethe veterans throughout all of
our home care services?
I think that's like hey,leading edge idea, really smart.
Another one tracking US healthcare spending by health
condition and county.
This was in JAMA, really mademe think of the Dartmouth Atlas,
but there was some great stuffactually in that article and so

(43:55):
just want to make sure you guysdidn't miss that one.
Another one kind of poking onprivate equity.
What happens to care whenprivate equity firms buy hospice
providers and so, court, youwant to say something about that
?
I'm going to be a broken record, like you know.
It ain't good when usuallyprivate equity and we
interviewed recently a candidateand was doing good margins

(44:18):
really a good person, chaplainby background, I loved his
balance of mission and heartPrivate equity calls up and says
we need 15% more margin andhe's like how, where is it going
to come from?
He was already pulling off theimpossible and I don't want to
hear excuses.
Just go make it happen.

(44:39):
And what we learned from ourpodcast last year with Laura
Katz Olson, who wrote the bookEthically Challenged.
They treat it like a vendingmachine.
That should insult us.
The most vulnerable populationis people at the end of their
life and they're like we justwant to extract a margin.
I don't really care about thebusiness itself.
We just want to treat this likea vending machine so we could
get our returns, and there are alot of people that are

(45:06):
complicit in this.
There are state employee plansthat that's where their
retirement funds and I don'tthink many of us know that.
We all want our 401k or 403b togrow, but would you want it to
grow to know that this isactually the implications of
that?

Cordt Kassner (45:15):
You know I had two thoughts around this.
One is the topic private Cordtand hospice.
Private equity is already in somany other fields, so many
other industries, that I thinkhospices probably need to learn
from our colleagues that havealready experienced some of this
.
So I think that's going to be atarget to keep our eye on this

(45:39):
year.
Next year in particularly, Ithink we're going to see a lot
of private equity mergers,acquisitions going on.
So one thing is the topic.
The other thing that I want togive a call out to are the
people who were involved in thispodcast.
I remember being a teenager, Iwas talking with a physician who

(45:59):
said Cord, it doesn't matterwhat the topic is, it doesn't
matter if you're interested init or not.
If you have an opportunity tobe around a world-class leader,
go to the grand rounds, go tothe session.
You will learn something, andthat's kind of what happened

(46:19):
here.
This podcast is with Ira Bayakand Jennifer Ballantyne, who are
amazing leaders in the field,and I feel the same way about
both of them and they'relongtime friends and colleagues.
But if they write the book, ifthey participate in a podcast,
if they're putting on a webinar,I'm going.

(46:40):
I will learn something becausethey're just top-notch folks and
I.
That's what got my attentionmore than the Judi topic
Lund-Person I was like, Judi,look at these people who are
participating.

Chris Comeaux (46:51):
Yep, love Ira, and he obviously thinks the
world of you.
We had him on a podcast at theend of the year and so, yep, all
right, well, I'm going to tryto land the plane here Just a
few more.
So, yep, all right, well, I'mgoing to try to land the plane
here Just a few more.
Cms pulls the plug on projectsaimed at improving care and
saving on costs.
This was in KFF, so that'sgoing to be interesting.

(47:14):
Is this a harbinger?
And so one of the sightings wassomething about the $2 generic
drug initiative.
They're canceling this $2generic drug initiative
initiative.
They're canceling this $2generic drug initiative.
So is that a harbinger?
That'll be interesting to see.
It was on Judy Lundpersonpodcast last year.
Judy said something I'm like,wait a minute, did I just hear
you right?
Did you just say that there arezero programs that literally

(47:36):
have come out of CMMI?
Meaning went through theprocess of CMMI, which the
original idea under PPACObamacare was.
We'd have this way toexperiment with innovation and
if we see a great idea, we don'thave to go back through the
legislative process.
It just gets kind of graftedinto Medicare.
Zero items kind of made thatpathway Now, not to say that

(47:56):
some of the thought processhasn't influenced it, but as far
as like a new benefit, there'snone.
So if you take a Dogeperspective, if all those
dollars spent, is it a goodreturn on investment?
And so it's going to beinteresting to see if that gets
looked at.
Next, is Medicare ready foraging in America?
Home-based care offers hope.

(48:18):
So this was Jonathan Fleece andSteve Landers from the Alliance
and really kind of think pokingon.
Like you know, is Medicareready for the tsunami?
And home-based care is part ofthe solution, and so kudos.
Jonathan Fleece is an amazingleader, amazing thought leader,
and Steve Landers at theAlliance.
So I thought that was a reallygood one.
I wanted to kind of callattention to this was in Forbes

(48:41):
Pharmacies of the Colin fourkeys to reinventing reinventing
the brick and mortar businessmodel.
You know kind of alluded to itearlier, so I'll chase the
rabbit.
I'm such a geek for Jim Collinsand so the whole point of the
hedgehog concept is whatWalgreens like their hedgehog
was every person that walks intothat pharmacy, that pharmacy.

(49:02):
If we could increase theirrevenue per person, then that's
our business model.
And you go, how did Walgreensafford, like this amazing street
corners?
Because that was their hedgehog.
But the key thing, if they alsomaybe didn't read Colin's book
about them, colin said you haveto keep readdressing your
hedgehog, you have to keeplooking at it.
So if you go back to his bookbefore that Built to Last, we

(49:26):
actually incorporate this intoour T-SAN logo.
Organizations that are built tolast that don't maybe Cordt
forget, but they lose the wisdomof their hedgehog are like a
hurricane.
There's all this chain swirlingabout and they're somewhat
unchangeable core of theirmission, vision and values.
T.
R.
you look at our TCN logo,that's why we have the swirl in

(49:47):
the logo.
We got that from Collins andbuilt to last, and so it's
really interesting that thisarticle about the pharmacy of
the future is poking on one ofthe key.
Like if you walk away from goodto great and go, oh, I got to
be in every street corner, thatwasn't the learning lesson.
The learning lesson was theirhedgehog, and then the street

(50:07):
corner became a tactic andstrategy, but they lost the
actual hedgehog and then nowthey're loaded with all these
huge assets, as you're saying,like closing down.
It'd be interesting to see asanyone figure out a use for
those closed down Walgreens, asmaybe they shift to less brick
and mortar.
So a couple of interestingpearls in that article.

(50:27):
Last one avoidable mortalityrises in the United States,
bucking global decline.
So in other words, this was inBecker's.
In other words, the rest of theworld is getting better at
mortality and we in the UnitedStates are getting worse.
And guess what?
We're spending more and more.
If you and I were looking atthat business Cord, we'd say,

(50:49):
well, that's not right.
We're spending more and we'reactually getting worse outcomes.
There's something wrong withthat equation.
That's why we just dropped thatpodcast with TR Reid and then
also kind of why we're going tobe dropping another podcast to
maybe influence, I imagine.
I know that Trump didn't run onhealthcare.
They're obviously addressing awhole bunch of other things, but

(51:10):
at some point here's myprediction when we start getting
healthcare renewals becausehealthcare spending last year, I
think, was either nine or 10%,so when the insurance companies
are going to look at that andthen all the other challenges
that they're dealing with Ididn't actually cite a
UnitedHealthcare article thismonth, but there's a whole lot
of stuff that keeps coming outabout United I think we're going
to be seeing some pretty steepincreases, that annual renewal

(51:35):
where they come back around andsay okay, let's look at your
health benefits.
What do you mean?
A 25?
I can't absorb a 25% rateincrease.
We're not getting that revenuerate increase.
That's going to start coming toa head with a whole lot of other
economic stuff probably hitting, and then what's going to
happen?
I hope it means you know what.
Let's look at the dang systembecause the system is
fundamentally flawed.
Let's quit just rearranging thechairs on the deck of the

(51:58):
Titanic, because we're gettingworse compared to the rest of
the world, and maybe that's thetime we start to really address
the fundamental issues ofhealthcare.
If it was Christmas, that'swhat I would ask Santa Claus for
.

Cordt Kassner (52:09):
There you go.
Well said, you know.
I know we kind of reflect onthese news stories and are
trying to build in a minute totalk about why are these stories
important?
As I take a look at your listthat you've reviewed here, which
you covered a lot ofinteresting ground, it occurs to
me that over the last year orso, a lot of your focus is

(52:33):
usually around the categories ofmission moments and the
healthcare staffing side, butthis month almost half of the
articles you selected werearound reimbursement and patient
family, future customerdemographics.
Do you think that's just afunction of March articles that
were available or is this abigger trend to keep an eye on?

Chris Comeaux (52:57):
Man, that's very observant of you.
That's what I love about you.
About data and I didn't kind ofthink about it till you just
asked the question I do thinkthere's a general kind of ethos
of there's a lot of crazy stuffcoming out of DC, but I don't
know what that means for me.
So it's almost like people aresitting on the sidelines.
Yet in fact this will go in asecond to our master class for

(53:21):
this month.
I just want to do anintroduction of leadership, and
so Dr Thayer will talk about.
There's a trajectory to things,almost like an inertia.
There's an inertia of thedemographics that doesn't matter
what happens in DC.
The baby boomers are aging andthat's going to bring an inertia
, and so I think that's what'sdriving and then, because of
that, it has a spillover effect.
We got to do something aboutthe reimbursement stuff, and

(53:46):
then there's a rhythm of thingslike med pack et cetera.
So I think if we kind of stepback this is kind of Chris
reading the tea leaves I thinkeverybody's standing on the
sidelines, are going.
I don't know what the hell isgoing to happen, and so we're
kind of waiting and seeing, butyet there are certain things
that are just playing out,whether we're waiting and seeing
or not, that that the babyboomers are aging and that's got
a spillover effect and I dothink that's going to come to a

(54:06):
head.
Be interesting as we get intolike late summer fall.
I would wonder if our volume ofarticles and like Holy crap,
there's so much we can highlighton a day-to-day basis.
It's going to get harder andharder on the 15.
Maybe I'm right, maybe I'mwrong on that.
We'll have to see.

Cordt Kassner (54:22):
Good points, thanks.

Chris Comeaux (54:24):
Any other questions of me?

Cordt Kassner (54:26):
You know you had asked about or commented around
the hope tool and how impactfulthat may be for hospice.
It might be used as a oasistool that they use in home
health and tie units toreimbursement.
Where do you think that's going?

Chris Comeaux (54:47):
I do think that's interesting.
I think it was last month.
We talked a whole lot moreabout that.
I do think hope is going to beour version of OASIS, and so
that is one you and I are goingto be talking more and more.
Right now, the MRs are tryingto position how do we
accommodate what hope is goingto bring?
So I think, like in thesummertime, we're going to start
getting a little bit of ananxiety of oh my God, this is

(55:07):
real, this is going to happen.
Is the EMR vendors ready?
Are we trained?
Do we know what we're going todo operationally?
But I do think it is going to beour version of Oasis, and so
right now, it's probably thedevil in the details of how
we're going to do it.
But if you step back and justget on the top of the mountain
for a second, this is going to,in the long term, be very
transformative to what we do.
You could just, if you knowanything about Oasis and home

(55:28):
health.
There are multiple, there's ahuge assessment, and that huge
assessment dictates multiplelevels of reimbursement, and so
I think, as a concept, you couldbet that that's where we're
going.
You're going to get a littlebit more of a pay for
performance system.
That's going to be a whole lotmore complex than what we deal
with today, but again, I thinkyou and I are going to be
talking about this a whole lotmore as we go forward.

Cordt Kassner (55:51):
Well, just real briefly, I'll give a shout out
to our friend Jennifer Kennedyover at CHAP.
She is not only a regulatoryguru but she has been putting
out regular podcasts andpublications around helping
hospices prepare for the HOPEassessment tool coming, and you

(56:11):
don't have to be accredited byCHAP in order to get access to
these things Christmas But Iwould sure point all of the
listeners in her direction totake a look at the advice that
she's giving in preparationGreat resources.
Quite like a healthcare workerwill get exposed to human

(57:08):
anatomy, the worker will getexposed to human anatomy.

Chris Comeaux (56:26):
Well said, well, great month, right, great month.
I think it's going to getbusier and busier as we go into
the year.
All right, I think I'm up thismonth on masterclass and so
actually I've just given acouple of keynotes and I
released my book, the Anatomy ofLeadership, last Christmas, so
December 23, christmas, not 24.
Now I'm getting asked to comeand do a lot of keynotes and

(56:48):
it's really affirming that.
You know, what I try to do is,if you Google the word
leadership, you get six billionhits.
How do you make sense of such avast body of knowledge?
So, kind of like, what youenjoy do is you scour all these
resources and kind of say, hey,this is what you need to know on
a day to day basis.
I'm trying to do that from aleadership perspective and offer
folks this is a meta framework,like a table of contents of

(57:12):
what is leadership, hence theterm the anatomy of leadership.
Quite like a health care workerwill get exposed to human
anatomy, worker will get exposedto human anatomy.
That's why we also thenlaunched the podcast.
So we have the Anatomy ofLeadership podcast, because that
table of contents offers thisopportunity to bring great
thought leaders, and so we havesome incredible podcasts coming
out later this year.

(57:32):
One of my favorite mentors isQuint Studer.
I actually have him coming upright next after we drop this
podcast together.
So I just want to offer peoplethe macro of framework of the
book.
And it actually starts with mymentor, Dr Lee Thayer.
He was like a human Yoda I feellike a young Skywalker sitting
at his feet, and so when I'mcontemplating this book, I sent

(57:53):
him an email because I neverheard the guy who I would call
like a leadership Yoda, neverheard him actually come down to
a definition and said hey, drThayer, how would you define
leadership?
And I want you, I want to readhis email, which I have right at
the beginning of my book, andhe says this leadership, from
wherever it is exercised, hasthis universal characteristic it

(58:14):
changes the course of thingsfor the better, if it's worthy,
leadership for the worst, if not.
Whether that's changing thecourse of a conversation or
changing lives yours first, thenothers, influencing how future
lives will be lived and futureperspectives altered, the
performance of an organizationor the piece of an organization,

(58:37):
of a gathering, a group, acommunity, a human endeavor like
music or marriage, or a wholesociety's trajectory.
This guy thought so deeplyabout stuff.
There's so much packed into hisemail response.
In other words, leadershipchanges the course of history,
the history of life orrelationship, a vocational

(58:58):
domain, a community or anorganization.
And here's kind of thepunchline.
Without the intervention ofcompetent leadership, things
will simply evolve in thedirection of the course that
they're on, that inertia thingthat we were talking about
earlier.
With worthy leadership, thetrajectories change for the
better for all those involved,change for the better for all

(59:24):
those involved and thus for thelarger social systems of which
they're a part.
So, by this measure, are you aleader?
And so then what I go on tounpack in the very kind of front
part of the book, which is thewhy of the anatomy of leadership
, that I believe there are fivecomponents, if you will, of
leadership self-mastery, caringfor others, influence, intention
and cause and purpose.
So I'll take future masterclasses, you and I will keep

(59:46):
kind of going, so you're up ondeck next month, and then I'll
pick up on self-mastery, caringfor others, influence, intention
and cause and purpose.
So that's our master class forthis month.
Any final thoughts before Iclose this out?
Court.

Cordt Kassner (01:00:07):
You know I like the definition that Dr Thayer
gave there.
That is focused on outcomes,because it's the outcome of that
leadership that determines ifit is worthy leadership or not
and how to differentiate those.

Chris Comeaux (01:00:14):
It's almost like you've heard the man, because he
would say the only measure ofperformance is performance
itself.
All right, well, let's wrap upto our listeners.
We so appreciate you.
Please subscribe.
If this is your first timelistening, pay it forward.
We do this, especially thispodcast, in service of you,
scouring all these articles,getting up early, reading them
and saying, hey guys, this iswhat the quantitative data shows

(01:00:35):
, and then this is what we hopethat you don't miss.
And kudos to the work that Cordand Joy do every morning in
service of you.
We're going into interestingtimes.
You got to know what's coming,so that's why we do this
particular episode of TCN Talksevery month.
So, as I always do want toleave you with a quote, this one
I got from the newsletter onMarch the 3rd February teaches
us to endure.

(01:00:56):
March reminds us to embrace newbeginnings.
Thanks for listening to TCNTalks.