LVF S1 EP11 - Navigating the Gray: The Role of Hospice Pharmacy with Dr. Jason Kimbrel
Last Visit First
In the rigid world of healthcare, pharmacy is often black and white: a diagnosis leads to a specific drug, and a lab value dictates the dose. But as Dr. Jason Kimbrel reveals in this episode, hospice pharmacy is different. It is an art form that requires "living in the gray." As the Chief Operating Officer of Yellow Leaf Consulting and a former NHPCO Section Leader, Dr. Kimbrel joins host Tom Maxwell to dismantle the industry’s most persistent myths about medication at the end of life.
Dr. Kimbrel takes listeners on a journey through the evolution of hospice pharmacy, from the early days of liquid morphine (Roxanol) to the complex regulatory landscape of today. He shares the defining moment of his career—the heartbreaking "Vitamin Story"—where a caregiver spent hours crushing multivitamins for her dying husband simply because no one had taught her otherwise. This failure sparked the creation of the BUILD Model, a communication framework Dr. Kimbrel developed to help clinicians navigate the delicate process of de-prescribing without making families feel abandoned.
Beyond the bedside, this episode dives deep into the business of hospice pharmacy. Dr. Kimbrel breaks down the history of critical regulations like CR 8358 and the two-tier payment system, explaining how they reshaped administrative burdens. He offers candid advice for hospice CEOs on managing formularies, avoiding the traps of "per diem" pricing models, and understanding when it makes financial sense to bring a pharmacist in-house.
From debating the stigma of methadone to addressing the crisis of vanishing 24-hour community pharmacies, this conversation bridges the gap between clinical compassion and operational strategy. Whether you are a nurse struggling with symptom management or an executive analyzing pharmacy spend, Dr. Kimbrel’s insights prove that the right medication strategy is not just about compliance—it is a final gift of comfort to patients and their families.