Navigating the Gray: The Role of Hospice Pharmacy with Dr. Jason Kimbrel скачать в хорошем качестве

Navigating the Gray: The Role of Hospice Pharmacy with Dr. Jason Kimbrel

From clinical rotations in Maine to guiding strategy at a national scale, Dr. Jason Kimbrel has defined his career by "living in the gray." As the COO of Yellow Leaf Consulting and a former NHPCO section leader, Jason bridges the gap between rigid medical rules and the compassionate, complex reality of end-of-life care. In this episode, Jason joins Tom to dismantle the industry's biggest medication myths—from the fear that "morphine kills" to the regulatory nightmares of Medicare Part D leakage. They dive deep into the origins of the hospice pharmacy movement, the history of liquid morphine (Roxanol), and the heartbreaking "Vitamin Story" that exposed a massive gap in how clinicians handle de-prescribing. Plus, Jason breaks down the "BUILD Model" for difficult conversations and advises CEOs on when it makes financial sense to bring a pharmacist in-house. In this episode, we cover: -The "Gray Area" of Hospice Pharmacy: Why success in end-of-life care requires moving beyond black-and-white hospital protocols to focus on comfort. -The Art of De-prescribing: How to stop unnecessary medications without making families feel abandoned—preventing the "cereal bowl" effect of too many pills. -Debunking the "Morphine Myth": Addressing the deep-seated fear that hospice opioids are meant to hasten death rather than manage pain. -The Crisis of Experience: How the decline in nurse tenure (from 10 years to 2) is creating a knowledge gap in pharmacology that leaders must address. -Pharmacy Access Danger: The growing risk of "pharmacy deserts" as 24-hour community pharmacies disappear, threatening 3 AM crisis management. -Leadership Strategy: Why CEOs must review formulary utilization quarterly and stop letting vendors dictate their payment models. -The Pharmacist in the IDG: The critical need to integrate pharmacy expertise into the Interdisciplinary Group to improve HOPE scores and outcomes. Timestamps: -00:09 Introduction to Dr. Jason Kimbrel -01:20 The Superpower of "Living in the Gray" -05:00 The History: Phyllis Grauer & Roxane Labs -08:52 The M&A Journey: From PCCG to Optum -10:37 The Meaning Behind "Yellow Leaf" -12:54 What Makes Hospice Pharmacy Unique? -16:47 Addressing the "Morphine Kills" Myth -21:16 The Vitamin Story: A Failure in De-prescribing -28:00 The BUILD Model Explained -34:06 Misunderstood Meds: Haloperidol & Methadone -43:30 Medicare Part D Leakage & "Call Letters" -44:00 Regulatory History: CR 8358 & 10573 -51:47 CEO Advice: Managing Formularies & PBMs -59:06 Drug Shortages & Sub-Q Administration -01:02:18 The HOPE Assessment & Symptom Management -01:07:26 The Pharmacist's Role in the IDG -01:17:29 When to Hire an In-House Pharmacist (1,000 ADC) -01:24:40 The Crisis of Community Pharmacy Access -01:33:00 The "Billy" Story: Ewing's Sarcoma & Legacy Resources Mentioned: -Book: Palliative Care Consultant: Guidelines for Effective Management of Symptoms (The "PCC"): https://www.amazon.com/Palliative-Car... -Model: The BUILD Model (Build, Understand, Inform, Listen, Develop): https://allianceforcareathome.org/wp-... -Regulation: CR 8358 (NDC Reporting Requirement): https://www.cms.gov/medicare/medicare... -Regulation: CR 10573 (Two-Tier Payment System): https://www.cms.gov/medicare/payment/... -Person: Phyllis Grauer (Industry Pioneer):   / phyllis-grauer-pharmd-1ba86b10   Special thank you to our sponsors: -Premier Sponsor: Trella Health: https://trellahealth.com/ -Premier Sponsor: Homecare Homebase: https://hchb.com/ -Maxwell TEC: https://maxwelltec.com/ -StenoHealth: https://www.stenohealth.com/ -IntellaTriage: https://intellatriage.com/ Check out Last Visit First on other platforms: -Apple Podcasts: https://podcasts.apple.com/us/podcast... -Spotify: https://open.spotify.com/show/3iSKGRv... -YouTube:    / @lastvisitfirstpodcast   -Website: https://www.lastvisitfirst.com -LinkedIn:   / last-visit-first   About Last Visit First: In home health and hospice, the start of care usually begins with the final visit in mind—because every decision becomes a memory. 'Last Visit First' challenges the industry to prioritize quality, connection, outcomes, and dignity right from the start. Hosted by industry veteran Tom Maxwell, we sit down with the CEOs, innovators, and clinical leaders shaping the future of Care at Home. We bring you the conversations that drive change, from leadership strategies to the innovations redefining patient care. Join the Conversation: If you enjoyed this episode, please Subscribe and leave a comment below. It helps us bring more incredible guests to the show.