Enclara Pharmacia is continually working to help hospices adapt to the current business and regulatory environment and prepare for what lies ahead. In this year-end wrap-up, Enclara leaders share their observations, accomplishments, and plans for the year ahead.
This year, we advanced our commitment to empowering hospice providers, caregivers, and associates by simplifying processes, driving innovation, and strengthening the human connection central to the hospice mission. “You Deliver the Care. We Make it Easier” remains at the heart of our mission in 2025.
Mark Morse – Chief Executive Officer
Enclara entered 2024 as the largest hospice pharmacy solutions provider in the country by average daily census. The fact that we continued to grow this year is a testament to the service, value, and innovation we provide to each of our hospice clients. We have had a number of hospices return to us after trying other pharmacies. Many told us that the cost savings they expected didn’t materialize and that the service just couldn’t compare. The key to our success is treating each hospice client as if they are our only hospice client. Every hospice matters because every patient matters.
We are continually exploring ways to enhance our value proposition at every level. Our quality improvement team scours our data to enhance the user experience for hospice nurses. Our account and clinical management teams work proactively with hospice leaders to help them provide the best possible care experiences in accordance with their organizational goals and values. By taking the time to listen and learn, we identify and meet emerging needs through new programs and services.
The next year will bring both challenges and opportunities. Some are already in place, including the CMS rollout of the Hospice Outcomes and Patient Evaluation (HOPE) assessment tool and Special Focus Program. Others are more speculative. In 2024, we saw the introduction of the Hospice CARE Act in the House of Representatives, which proposed some of the broadest changes and improvements to hospice benefits that the industry has seen. Additionally, a change in presidential administration in Washington always brings the possibility of regulatory changes we cannot anticipate. Regardless of what the future brings, Enclara will work with hospices to prosper in the face of change.
Deanna Douglass, PharmD – SVP, Business Development
In the past year, Enclara has been developing additional services based on customer feedback and industry trends. For example, with the rise of more profitable biologics, many infusion providers are shifting their focus away from the hospice market, so we launched infusion services out of our Avanti Health subsidiary in New York. That service is now expanding to neighboring states through a next-day mail-order program with virtual training.
We are also looking at other areas where we can provide value. Hospice is and will remain our primary focus, but as our hospice partners branch out into other lines of business, we want to be able to continue to meet their needs. We are actively developing pharmacy models for Program of All-Inclusive Care for the Elderly (PACE) participants and expect to pilot some programs in 2025. Community-based palliative care is finally seeing some traction, too, with several states incorporating it into their Medicaid programs. We recently introduced a palliative care patient add-on to our electronic health record integrations to help streamline documentation and care coordination for hospices offering this service and are talking to providers about other ways we might be able to support them.
The hospice pharmacy market has changed a lot in recent years, and many hospices are taking a fresh look at their pharmacy programs. Our business development, implementation, and education teams continue to build capacity to meet demand and provide a smooth onboarding experience for hospices of all sizes. We look forward to continued growth in the coming year.
Megha Kadiyala – SVP, Product Management
The healthcare industry continues to grapple with how emerging artificial intelligence capabilities can benefit patients and healthcare providers. A significant opportunity is optimizing the continuum of care to ensure patients are able to access the right care for their needs at the right time. An important piece of that puzzle is greater coordination between hospice admissions and acute care. As more organizations turn to technology to better manage care transitions, we are seeking opportunities to leverage that on the pharmacy side. For example, one of the top pharmacy-related challenges for hospices is obtaining medications upon admission for patients being discharged from the hospital, sometimes late in the day and with little warning. Upstream integrations using predictive analytics could potentially help our hospice partners anticipate admission needs and solve this challenge. We are actively looking into leveraging technology to ease the transition.
In 2024, we focused on a number of enhancements to our E3 Pro™ mobile and web-based medication management platform to make nurses’ lives easier at admission and throughout a patient’s hospice journey. This includes the ability for a nurse to personalize their experience based on what features they use, the ability to complete tasks more efficiently, especially when ordering multiple medications, and improving the local pharmacy ordering experience.
As we kick off the new year, user feedback continues to inform our product roadmap. In-app ratings and comments inspire some of our best ideas for new features and refinements. Meanwhile, in-person interaction with nurses and leadership helps us better understand how our tools are used in the real world. This informs our long-term technology strategy as we continue to lead the industry.
Anthony Dameika – VP, Marketing and Communications
Facilitating communication with our valued hospice clients is a core part of my team’s role at Enclara. A key milestone in 2024 was the continuation of our Connected Care Community, an essential initiative in our voice of customer strategy. Open to all nurses at Enclara client hospices, this initiative fosters collaboration and insight sharing, directly influencing improvements across our organization. New offerings like Micro Courses from the Enclara Learning Academy™, designed for completion in under 10 minutes on a mobile device, are a direct result of this feedback.
Additionally, our pharmacists continue to produce a wealth of clinical content available on our website and as contributors to industry publications, amplifying our impact on patient care and the nurse experience. These included Preventing the Prescribing Cascade: Lessons from Hospice and Palliative Care in McKnight’s Home Care and How Pharmacists Can Help Reduce Nurse Turnover in HomeCare Magazine. Internally, we remain focused on empowering our associates with a culture that encourages taking action, navigating change, and collaborating to solve industry and internal challenges while feeling supported and heard.
Looking ahead, we will remain focused on helping current and prospective clients fully understand the breadth of Enclara’s value proposition, which includes improving patient care, managing utilization, and delivering a best-in-class nurse experience. These efforts aim to give our hospice partners a competitive edge in nurse recruitment and retention while reducing administrative burdens and compliance concerns. By fostering collaboration, creativity, and compassion, Enclara will continue setting the standard for hospice and palliative care pharmacy in 2025 and beyond.
Kerry Lord – SVP, Information Technology
In 2024, Enclara’s information technology team focused on operational efficiency, automation, and security. These “behind the scenes” innovations benefit our hospice clients and their patients in myriad ways. We also continue to stay ahead of emerging information security and compliance requirements, including renewing our HITRUST® certification of major systems.
One of our key initiatives is enhancing many of our core data systems, allowing us to expand bandwidth and add resiliency while improving performance and stability for client applications. We supported a number of upgrades in our mail order fulfillment centers, including the integration of new robotic dispensing systems, which can safely and accurately fill, label, and cap a bottle of tablets in under a minute. Between our new equipment and software improvements, we have substantially increased capacity and operational efficiencies.
Seamless interoperability with electronic medical records (EMR) systems is a core part of our service offering. In 2024, we automated our process for hospices transitioning from one EMR to another, enabling greater flexibility for our clients. We also developed integrations with two additional EMR systems which we will announce soon. Our most exciting innovation is a real-time bidirectional medication interface with MatrixCare, allowing medications to be entered in either the EMR or our own E3 Pro platform with seamless synchronization. We anticipate the positive client feedback and stability associated with this interface will encourage more EMR vendors to enable bidirectional capabilities in the future.
Ryan Krout, PharmD – VP, Clinical Management
A number of our hospice partners are now using predictive analytics to better anticipate patient needs and disease progression. We have been working on leveraging this information to help hospices and clinicians make more informed prescribing decisions. This has led to reduced medication waste and opportunities to improve patient care. Rolling out these predictive capabilities to additional hospices with the support of Enclara’s clinical experts is one of our top priorities for 2025.
Nurse turnover and onboarding continue to be top concerns for our hospice partners, so in 2024 we significantly expanded our library of courses and reference materials on managing symptoms and diseases commonly encountered in hospice care. This provides convenient access to pharmacy best practices to support nurses in delivering care and educating patients and caregivers. We also piloted a program to help caregivers understand symptoms and medication administration. We will apply what we learned to continued efforts to help hospices empower and engage home caregivers.
While these materials are exclusive to Enclara clients via E3 Pro and the Enclara Learning Academy, our pharmacists also provide a wealth of palliative care guidance in our monthly Palliative Pearls newsletter that anyone can access. Additionally, with a new Symptom Follow-up Visit process included in the new HOPE tool for 2025, we have developed a valuable new ebook to help support and empower hospice teams. Crucial Conversations: Educating Patients & Caregivers on Common Symptoms in Hospice Care includes talking points on many of the most common symptoms encountered in palliative care so nurses can more confidently provide patients and caregivers with the necessary information to actively participate in their plan of care.
Patrick Leary – VP, Client Services
The account management experience has always been a key differentiator for Enclara, and it’s more important than ever as hospice utilization rates recover from their pandemic-era declines. Hospices continue to pursue efficiency and operational savings to meet growing demand while providing high-quality care that aligns with each patient’s goals and values. At Enclara, we do not see ourselves as just another vendor, but rather as a valued partner. Part of this is being an intensive listener, asking the right questions, and collaborating with our partners to find solutions. In some instances, it also means helping our hospice partners maximize the full potential of our tools and technology.
One of our big success stories has been helping clients understand the value of single sign on (SSO) user authentication for E3 Pro. Increased adoption of SSO led to a 25 percent drop in customer service calls for username and password support, which represents a lot of time savings and reduced frustration for hospice nurses. Sharing these statistics with our hospice partners has in turn led to more interest in pursuing this medication management solution.
Externally, one of the major trends in 2024 was an accelerating contraction of the retail pharmacy market, with the top three retail chains announcing the closure of thousands of pharmacy locations nationwide. This is particularly concerning for hospice providers, who were already facing challenges in the availability of 24-hour service and pharmacies’ reluctance to stock hospice and palliative care medications. This in turn has many of our hospice clients taking a fresh look at our home delivery program, which provides next-day and second-day shipment of medications directly to patients’ homes. Currently, about half of our clients use an all-local retail pharmacy access model, but by incorporating home delivery, hospices can limit courier runs to only the most urgent needs while ordering routine medications from Enclara for next-day delivery.
