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In Part Two of this thought-provoking conversation, Chris Comeaux and Robin Heffernan unpack the complex realities shaping the future of hospice under Medicare Advantage.
From the lessons learned in the VBID demonstration to the growing momentum behind “carve-in” models, this episode explores the tension between cost, quality, and patient experience—and what it will take to align all three. At the center of the discussion is a critical question: how do we design a system that truly rewards high-quality care while eliminating inefficiencies and poor outcomes?
The conversation dives into emerging models like concurrent care “bridge pathways,” which challenge the traditional binary transition into hospice and offer a more patient-centered approach to serious illness care.
It also tackles the impact of private equity, consolidation, and payer incentives—raising important considerations about accountability, network design, and the sustainability of mission-driven providers. For leaders navigating an evolving healthcare landscape, this episode provides both Clarity and challenge on what comes next.
Key Takeaways
- The VBID demonstration revealed both promise and limitations—strong outcomes are possible, but only with better network control and quality alignment.
- “Concurrent care bridges” may offer a more realistic and compassionate transition into hospice, improving patient experience and outcomes.
- Financial incentives must shift toward total cost of care, not fragmented payment models, to truly drive better patient outcomes.
- Consolidation is likely, but high-quality providers—regardless of size—can still thrive if value and outcomes are prioritized.
- Payer accountability and earlier palliative care engagement are key to reducing costs while improving care quality.
Guest:
Robin Heffernan, PhD, Co-Founder and CEO, Empassion
Host:
Chris Comeaux, President / CEO of TELEIOS and author of The Anatomy Of Leadership
The Anatomy of Leadership podcast explores the art and science of leadership through candid, insightful conversations with thought leaders, innovators, and change-makers from a variety of industries. Hosted by Chris Comeaux, each episode dives into the mindsets, habits, and strategies that empower leaders to thrive in complex, fast-changing environments. With topics ranging from organizational culture and emotional intelligence to navigating disruption and inspiring teams, the show blends real-world stories with practical takeaways. The goal is simple yet ambitious: to equip leaders at every level with the tools, perspectives, and inspiration they need to lead with vision, empathy, and impact.
https://www.teleioscn.org/anatomy-of-leadership
I am currently the President/CEO of Teleios Collaborative Network which is like a co-op of nonprofit hospice and palliative care organizations. I am also CEO of Teleios Consulting Group. The goal of the collaboration is to harness the best of each hospice and enable the network to better care in each community for the patients and families being served as well as introduce innovations across the membership network and work with payers for new innovative solutions for those dealing with serious or advanced illness.
I am also host two podcasts, Anatomy Of Leadership and TCNtalks. Anatomy of Leadership was inspired by my book "The Anatomy of Leadership" which I wrote for Leaders, visionaries, and change-makers. The podcast delves deep into the essence of purpose-driven and high-performance leadership.
The show guides you through a journey of discovery—revealing how effective leadership can significantly alter the trajectory of our teams, organizations, our lives, and the world at large.
We examine topics like:
- Self-Mastery
- Caring for Others
- Influence
- Intention
- Cause and Purpose
Bio
Over the years, I have become nationally known as a leader in our country’s hospice and palliative care industry, where I spent a large portion of my career as President/CEO of Four Seasons in western North Carolina, a 2009 American Hospital Association Circle of Life Award Winner. In 2005, the Carolinas Center for Hospice and End of Life Care honored me with the Peter Keese Leadership Award.
In 2006, I left Four Seasons for two years to build an alliance between the prestigious national healthcare consulting firm, the Studer Group, and Covenant Hospice in Pensacola. The vision was to transform, develop, and grow leaders throughout the hospice and palliative care world. With this venture from its infancy to an established coaching firm partnering with post-acute healthcare organizations from New York to California. I returned to Four Seasons in 2008 to apply everything learned in the trenches on leadership to an organization I knew and loved.
My hospice career began in 1997 at Covenant Hospice in Pensacola, Florida. Earlier in my career, where I worked with KPMG Peat Marwick, a “Big Four” CPA consulting firm, and with Cooper Industries, a Fortune 100 Company, in its Executive Development Program.
I have a Masters in Leadership from the Thayer Institute for Performance Virtuosity.
I am blessed to have a wonderful wife, Deshia and a proud parent of 5 children (3 boys and 2 girls). Love spending time outdoors with my family, reading, and learning in the mountains of Western North Carolina.
