The Critical Competencies Hospice Leaders Must Build for Value-Based Care Success | Part One

The future of hospice is being rewritten—and the organizations that prepare now may be the ones best positioned to serve patients in a value-based world.Healthcare is rapidly moving beyond traditional fee-for-service toward models focused on outcomes, total cost of care, and coordinated care delivery.  In Part One of The Critical Competencies Hospice Leaders Must Build for Value-Based Care Success, host Chris Comeaux sits down with Dr. Jessica Hubbs, Internist and Chief Clinical Officer at Advanced Care Innovations, to explore what this transformation means for hospice and palliative care leaders. Dr. Hubbs examines emerging models such as LEAD (Long-term Enhanced ACO Design) and why moving care further upstream could create both disruption and significant opportunity for hospice organizations.  The conversation explores how hospice's strengths in advanced care planning, complex conversations, patient goals and values, and interdisciplinary care could become increasingly valuable across the broader serious illness continuum. But succeeding in this new environment will require new capabilities.  Chris and Dr. Hubbs discuss the importance of end-to-end clinical care, complex primary care, care coordination, financial-risk readiness, and collaborative partnerships with ACOs and other risk-bearing organizations—and why the future may be less about competing for the patient and more about building integrated models around them. Episode HighlightsWhy hospice leaders need to understand the shift to value-based careWhat the LEAD model could mean for serious illness careThe opportunity to bring hospice expertise further upstreamCritical clinical capabilities hospice organizations need to developCombining hospice and palliative expertise with home-based primary careWhat ACOs and risk-bearing organizations want from hospice partnersGuest:  Dr. Jessica Hubbs, Internist and the Chief Clinical Officer at Advanced Care Innovations Host: Chris Comeaux, President / CEO of TELEIOS, author of The Anatomy of LeadershipTeleios Collaborative Network   /   https://www.teleioscn.org/tcntalkspodcast

Your culture isn’t defined by what your organization says it values—it’s revealed by the behaviors it allows, rewards, and repeats.In Part Two of Your Culture Isn't What You Say—It's What You Tolerate, host Chris Comeaux continues his conversation with author and leadership expert Tom Foster about what it takes to intentionally build a strong organizational culture.Tom challenges leaders to look beyond KPIs and productivity metrics and examine whether the behaviors being measured actually support the organization’s mission and purpose. Using examples from healthcare and home health, they explore how well-intentioned performance measures can sometimes work against the outcomes leaders truly want. Chris and Tom also discuss practical ways to evaluate culture—including examining behaviors, organizational systems, customs and rituals, and actually going to see the work firsthand. The conversation explores the relationship between leadership, workplace culture, strategy, employee development, organizational behavior, and performance—and why culture and strategy continuously shape one another. One leadership principle captures the heart of the episode:“Reality always wins. The biggest challenge for the leader is simply to get in touch with it.” — Tom FosterIf you're a healthcare leader, hospice professional, nonprofit executive, or business leader, this episode will challenge you to look beyond the culture you intend to create and examine the culture your organization is actually producing.Featuring: Tom Foster, President of Foster Learning Corporation and author of Premeditated Culture: The Consequences of What We Tolerate,Host: Chris Comeaux, President / CEO of TELEIOS, author of The Anatomy of LeadershipTopics: Organizational Culture | Healthcare Leadership | Hospice Leadership | Accountability | Leadership Development | Workplace Culture | Organizational Behavior | Purpose-Driven Leadership | Culture ChangeSubscribe to TCNtalks and Anatomy of Leadership for more conversations on leadership, healthcare, organizational culture, and building high-performing teams.Teleios Collaborative Network   /   https://www.teleioscn.org/tcntalkspodcast

Your culture isn’t what your organization says it values—it’s what your leaders are willing to tolerate.In Part One of Your Culture Isn't What You Say—It's What You Tolerate, host Chris Comeaux sits down with Tom Foster, President of Foster Learning Corporation and author of Premeditated Culture: The Consequences of What We Tolerate, to explore how leaders intentionally—or unintentionally—shape organizational culture.Tom challenges leaders to look beyond mission statements, values on the wall, and aspirational language. Instead, he introduces the Culture Cycle and explains why leaders should start by defining the behaviors they want, then examine what happens when those behaviors collide with the consequences of reality. Because ultimately, the behaviors leaders reinforce, ignore, or allow to continue become the organization's real culture. Chris and Tom also explore why culture often deteriorates through seemingly small lapses in accountability and how pressures facing healthcare and hospice leaders—including workforce shortages, regulation, compliance, productivity demands, reimbursement pressures, and rapid change—can expose the difference between an organization’s stated values and its actual behaviors. In This Episode:Why culture lives in what leaders tolerateThe difference between accidental and intentional cultureTom Foster’s Culture CycleWhy leaders should define behaviors before beliefsHow accountability—or the lack of it—shapes workplace cultureWhy consultants should clarify before they fixHow small leadership omissions can slowly erode cultureHow healthcare pressures test organizational valuesWhat hospice leaders can learn about connecting behaviors with purposeThe question for every leader: Are the behaviors happening inside your organization consistent with the culture you say you want?▶️ Listen to Part One now, and subscribe so you don’t miss Part Two of this important leadership conversation.Featuring: Tom Foster, President of Foster Learning Corporation and author of Premeditated Culture: The Consequences of What We Tolerate,Host: Chris Comeaux, President / CEO of TELEIOS, author of The Anatomy of LeadershipTopics: Organizational Culture | Healthcare Leadership | Hospice Leadership | Accountability | Leadership Development | Workplace Culture | Organizational Behavior | Purpose-Driven Leadership | Culture ChangeTeleios Collaborative Network   /   https://www.teleioscn.org/tcntalkspodcast

The hospice moratorium may eventually end—but CMS scrutiny of hospice is likely here to stay.In Part Two of The Hospice Moratorium: What CMS Is Really Signaling About the Future, Chris Comeaux and Cordt Kassner continue their conversation with Dr. Jennifer Kennedy, Vice President for Quality, Standards and Compliance at CHAP, about what hospice leaders should expect when the moratorium is lifted—and how organizations should prepare now.The conversation explores increased CMS enrollment scrutiny, changes of ownership, audits, SSVI, compliance programs, and the growing role of data and AI in identifying fraud and abuse.  Jennifer emphasizes that quality and compliance must work hand-in-hand and that hospices should begin treating audits and regulatory readiness as part of the cost of doing business. But greater regulation raises an important question: Can CMS become precise enough to eliminate bad actors without penalizing high-quality providers? The discussion examines how better data and AI could help regulators target fraud more effectively while protecting access, innovation, and legitimate hospice organizations. Most importantly, Jennifer reminds leaders that compliance cannot overshadow the mission.  Even in a more regulated future, hospice must remain centered on compassionate, patient-centered care and what matters most to the patient. In this episode:What could happen when the hospice moratorium endsWhy CMS scrutiny is likely to increaseBuilding a culture of compliance and qualityWhy hospices should budget for more auditsSSVI and the future of hospice oversightUsing AI and data to better identify fraud and abuseProtecting legitimate providers from regulatory overreachKeeping compassion at the center of hospice care🎧 Subscribe to TCNtalks | Anatomy of Leadership for conversations helping healthcare and hospice leaders navigate what’s next.Guest: Dr. Jennifer Kennedy, Vice President, Quality, Compliance and Standards with CHAPCo-Host: Cordt Kassner, PHD, Publisher, Hospice & Palliative Care TodayHost: Chris Comeaux, President / CEO of Teleios, author of The Anatomy of LeadershipTeleios Collaborative Network   /   https://www.teleioscn.org/tcntalkspodcast

The hospice moratorium may be temporary—but the changes it signals for hospice oversight could be permanent.In Part One of The Hospice Moratorium: What CMS Is Really Signaling About the Future, Chris Comeaux and Cordt Kassner, PhD, are joined by Dr. Jennifer Kennedy, Vice President for Quality, Standards and Compliance at CHAP, to unpack why CMS implemented the hospice moratorium and what it could mean for the future of the Medicare hospice benefit.The conversation explores the growing federal focus on fraud and abuse, rapid hospice market expansion, Medicare enrollment, accreditation oversight, and increasingly sophisticated screening of providers.  Jennifer also explains why she believes the moratorium could be extended—and why CMS scrutiny is unlikely to disappear when the moratorium eventually ends. But there’s another side to the crackdown: legitimate hospice providers can get caught in the same regulatory net designed to stop bad actors.  What happens when high-quality organizations want to expand into rural or underserved communities but can’t? And can CMS become precise enough to protect access while aggressively pursuing fraud? In this episode:What the CMS hospice moratorium actually meansWhy fraud and rapid market expansion triggered increased scrutinyWhether the moratorium could be extendedThe role of accreditation and enrollment screeningHow legitimate hospice providers may be unintentionally affectedWhy quality and compliance will define the next era of hospice oversight Guest: Dr. Jennifer Kennedy,Co-Host: Cordt Kassner, PHD, Publisher, Hospice & Palliative Care TodayHost: Chris Comeaux, President / CEO of Teleios, author of The Anatomy of LeadershipTeleios Collaborative Network   /   https://www.teleioscn.org/tcntalkspodcast

What if the frustration, anger, and resistance showing up in your organization aren't signs of disengagement—but signals that your people still deeply care?In Part Two of From Zombies to Zealots: Cultivating Passion and Purpose in Healthcare Leadership, host Chris Comeaux continues his thought-provoking conversation with DJ Mitsch, author, master coach, and founder of the Healthcare Coaching Institute, and Tasha Walsh, CEO and Executive Director of ConnectionsPlus Healthcare + Hospice.Healthcare and hospice professionals often enter the field because they feel called to the work.  But regulations, audits, documentation requirements, productivity pressures, and constant organizational change can gradually disconnect people from that deeper sense of purpose.  DJ challenges leaders to recognize what happens when meaningful, purpose-driven work becomes dominated by the language of compliance rather than creation. Using the real-world example of hospice audits and documentation pressure, the conversation explores how fear of financial clawbacks and increased scrutiny can ripple through an organization and contribute to caregiver burnout. Rather than ignoring those emotions, DJ and Tasha encourage leaders to acknowledge them—and use anger, fear, frustration, and even pushback as valuable information.As DJ explains, anger can become fuel for change.  Tasha takes that idea further: what lies beneath someone's frustration may be a deep commitment to patients, coworkers, or the mission.  Effective leaders learn to uncover that meaning, transform emotional energy into courage, and create space for difficult but necessary conversations. In This Episode, You'll Discover:Why purpose-driven healthcare professionals can become disconnected from their callingHow leaders can shift the organizational conversation from compliance to creationWhy anger, fear, frustration, and resistance shouldn't automatically be labeled “negative”How to use emotion as information—and transform it into constructive actionWhy taking a breath and really listening can change the direction of a difficult interactionHow leaders can create cultures where people feel safe bringing their authentic selves to workWhy organizational culture is shaped by what leaders repeatedly tolerate, encourage, and createHow healthcare leaders can become change agents rather than passive participants in a dysfunctional systemOne of the most powerful ideas from the conversation is that naming what people are experiencing can reduce its hold over them.  By giving language to fear, anger, and frustration, leaders can help their teams redirect that energy toward something more productive.And ultimately, the goal isn't simply to build a more “resilient” workforce.It's to create an environment where people are excited to come to life fully every day.What is the culture you're creating helping your people become—zombies or zealots?Guest:Tasha Walsh, LCSW, PCC CEO/ED of Connections Plus Healthcare + Hospice Darelyn DJ Mitsch, Author, Master Coach, and Chief Energy Officer, The Pyramid Resource Group, Home of the Healthcare Coaching Institute and Team Advantage Team Coaching Host:Chris Comeaux, President / CEO of TELEIOS, author of The Anatomy of LeadershipIf this conversation resonates with you, like, subscribe, and share this episode with another healthcare, hospice, or business leader who is working to create a more engaged, purpose-driven culture.Teleios Collaborative Network   /   https://www.teleioscn.org/tcntalkspodcast

What turns a passionate healthcare professional into a “zombie” at work—and what can leaders do to help reignite that sense of purpose?In Part One of From Zombies to Zealots: Cultivating Passion and Purpose in Healthcare Leadership, host Chris Comeaux is joined by DJ Mitsch, author, master coach, and founder of the Healthcare Coaching Institute, and Tasha Walsh, CEO and Executive Director of ConnectionsPlus Healthcare + Hospice, for a thought-provoking conversation about burnout, workplace culture, leadership energy, and reconnecting healthcare professionals to their calling.Healthcare professionals often enter the field with a deep sense of mission. But regulatory pressure, productivity expectations, audits, quality metrics, and constant organizational change can gradually disconnect people from the heart of why they chose this work. As DJ explains, when organizations focus primarily on mandates, productivity, and profitability rather than the human beings doing the work, healthcare can become transactional rather than transformational. DJ and Tasha explore why language is one of the most powerful indicators of organizational culture. Leaders can learn a great deal by listening not only to what employees say, but also to the emotional currents beneath words such as “pushback,” resistance, and disengagement. The goal isn't simply greater compliance—it's creating language and leadership practices that empower, clarify, and reconnect people to purpose. In This Episode, You'll Discover:Why passionate healthcare professionals can gradually become “zombified”How productivity and compliance can overshadow purposeWhy leaders should pay close attention to the language of their organizationThe difference between a workplace “zombie” and a purpose-driven “zealot”How leadership energy influences employees—and ultimately patient careWhy connection and belonging are essential to sustaining passionHow leaders can help employees reconnect with the mission that brought them into healthcareWhy changing workplace culture begins with how leaders listen, communicate, and show upA “zealot,” as DJ describes it, is someone who stays connected to purpose even when organizations change, leaders leave, or circumstances become chaotic. They remember that they belong to something bigger than themselves. For hospice leaders, healthcare executives, nonprofit leaders, and anyone responsible for organizational culture, this conversation offers a different way of thinking about burnout and workforce engagement: perhaps the answer isn't another program or initiative, but helping people rediscover the meaning, connection, and purpose already embedded in the work.Subscribe and don't miss Part Two of this conversation, as Chris, DJ, and Tasha continue exploring how leaders can transform healthcare cultures from burnout and disengagement toward greater passion, connection, and purpose.Guest:Tasha Walsh, LCSW, PCC CEO/ED of Connections Plus Healthcare + Hospice Darelyn DJ Mitsch, Author, Master Coach, and Chief Energy Officer, The Pyramid Resource Group, Home of the Healthcare Coaching Institute and Team Advantage Team Coaching Host:Chris Comeaux, President / CEO of TELEIOS, author of The Anatomy of LeadershipTeleios Collaborative Network   /   https://www.teleioscn.org/tcntalkspodcast

What is CMS really signaling about the future of hospice?In Part Two, Chris Comeaux continues his conversation with hospice experts Annette Kiser and Judi Lund Person about the Hospice Wage Index, the Final Rule, and what leaders should be preparing for now.They explore the larger shift toward increased CMS oversight, data-driven accountability, stronger documentation, scrutiny of non-hospice spending, and greater expectations around quality and value. From SSVI and PEPPER data to the mandatory hospice addendum, claims, and cost reports, the message is clear: hospice organizations need to understand their data and trends before CMS does.The conversation also looks ahead to the future of the Medicare Hospice Benefit, including potential payment reform, outcomes-based accountability, and the growing importance of accurate, auditable cost reports.Most importantly, Annette and Judi challenge leaders to look beyond compliance and keep patients and families at the center—using data not simply to satisfy regulators, but to identify gaps, improve care, and build stronger organizations for the future.If you lead a hospice or work in compliance, quality, operations, or finance, this is a conversation you don't want to miss.▶️ Watch Part Two and share it with your leadership team.🔔 Subscribe to TCNtalks and Anatomy of Leadership for more conversations exploring hospice, healthcare leadership, innovation, regulation, and the future of serious illness care.Guests:Annette Kiser — Chief Compliance Officer, Teleios Collaborative NetworkJudi Lund Person — Principal, Lund Person & AssociatesHost:Chris Comeaux — President/CEO of Teleios and author of The Anatomy of LeadershipTeleios Collaborative Network   /   https://www.teleioscn.org/tcntalkspodcast

What is CMS really signaling through the 2027 Hospice Wage Index and Final Rule—and what should hospice leaders be doing now?In Part One, host Chris Comeaux is joined by hospice regulatory experts Annette Kiser and Judi Lund Person to unpack the 2027 Hospice Wage Index and Final Rule and look beyond reimbursement to what CMS may be signaling about the future of hospice regulation, compliance, payment, and oversight.They explore the Hospice Election Statement Addendum, the Service and Spending Variation Index (SSVI), non-hospice Medicare spending, Part B claims, telehealth reporting, and why leaders should be examining their data through a quality and compliance lens.In this episode:What the 2027 Hospice Final Rule reveals about CMS prioritiesPreparing for the October 1, 2026 Election Statement AddendumUnderstanding SSVI and non-hospice spendingWhy CMS is increasing scrutiny of unrelated servicesTelehealth, G-code reporting, and eligibilityUsing SSVI and PEPPER data to identify trends and opportunitiesCMS reported that Medicare Part A and B non-hospice spending increased 160% from 2020 to 2024, exceeding $2 billion in 2024, with hospice patients responsible for approximately $510 million in cost sharing—a major reason this issue is receiving increased attention. fileciteturn0file0L130-L148The Final Rule tells you what CMS is doing. The details may tell you what CMS is preparing to do next.▶️ Listen to Part One, share it with your hospice leadership team, and subscribe so you don’t miss Part Two.Guests:Annette Kiser — Chief Compliance Officer, Teleios Collaborative NetworkJudi Lund Person — Principal, Lund Person & AssociatesHost:Chris Comeaux — President/CEO of Teleios and author of The Anatomy of LeadershipTeleios Collaborative Network   /   https://www.teleioscn.org/tcntalkspodcast

What if one of the most powerful partnerships in serious illness care is one healthcare leaders have largely overlooked?In Part Two of The Healthcare Partnership Nobody Is Talking About: Hospice + FQHCs, Chris Comeaux continues his conversation with Kyle Ahlenstorf about the opportunity for hospice and palliative care organizations to partner with Federally Qualified Health Centers (FQHCs) to create a stronger continuum of care.FQHCs bring primary and preventive care, behavioral health, care coordination, community health workers, telehealth capabilities, and deep connections within their communities.  Hospice and palliative care organizations bring expertise in serious illness and the ability to extend specialized care directly into the home. Chris and Kyle explore what could become possible when these strengths are intentionally connected. In this episode, you'll hear about:How hospice, palliative care, and FQHCs can collaborate beyond traditional referral relationshipsOpportunities to extend palliative and serious illness care into the homeThe role of care coordinators, referral specialists, and community health workersHow FQHCs integrate behavioral health, substance use disorder services, and telehealthWhat hospice leaders should understand about FQHC operations, federal funding, and the 340B Drug Pricing ProgramThe importance of EMR data sharing, quality reporting, and value-based careHow FQHCs participate in ACOs and shared-savings modelsPotential opportunities involving rural healthcare transformation grants and service co-locationWhy these partnerships could become increasingly important to the future of community-based healthcareKyle's message to hospice and palliative care leaders is simple: “Think of us as partners.”  Stronger community connections can help organizations better coordinate resources and serve patients across the continuum. If you're a hospice leader, palliative care professional, FQHC executive, healthcare executive, nonprofit leader, or anyone working in value-based and community-based care, this conversation offers a different way to think about partnership, access, and healthcare innovation.👍 Like this episode💬 Share your thoughts in the comments🔔 Subscribe to TCNtalks and Anatomy of Leadership for more conversations designed to challenge healthcare leaders, spark innovation, and inspire better leadership.Episode Topics: Hospice care, palliative care, Federally Qualified Health Centers, FQHCs, serious illness care, community health centers, healthcare partnerships, value-based care, behavioral health, 340B Drug Pricing Program, ACOs, rural healthcare, community health workers, care coordination, telehealth, preventive care, population health, healthcare leadershipGuest:Kyle Ahlenstorf, CEO of Infinity HealthHost:Chris Comeaux, President / CEO of TELEIOS, author of The Anatomy of LeadershipTeleios Collaborative Network   /   https://www.teleioscn.org/tcntalkspodcast