One Social Worker's Shift = One 8K Markup
Years ago, I was paid $20 for a hospice case.
Years later, I realized that moments like that shape what families report in CAHPS Hospice Surveys data that influences public ratings, reimbursement, and contract decisions.
One of my first patients was actively dying. I stayed with his family. Helped them prepare. Answered questions. Brought presence and calm into a space full of fear.
Hours later, he passed.
They weren’t panicking. They were ready. He wasn’t alone.
I walked away feeling like I did something meaningful but not measurable.
Too soft for systems.
Too human for spreadsheets.
This is why I was wrong:
In hospice and end-of-life care:
These domains aren’t part of Medicare Advantage Star Ratings, but they follow the same logic: human experience becomes system data.
When families say yes to questions like:
→ Those answers are not just feedback. They are financial levers.
In Medicare Advantage, a single CAHPS response , in domains like care coordination or customer service , can shift a Star Rating. A 0.5-star bump can unlock millions. So yes, presence moves metrics even if the system forgets who created the moment.
The Measurable Metrics Behind Presence
Hospice quality is evaluated through the CAHPS Hospice Survey, which directly measures emotional support, family communication, and caregiver training.
From CMS guidance to peer-reviewed research, there's growing consensus: presence and emotional support are not just meaningful, they’re measurable.
These are all areas where social workers play a central role, often without formal credit.
Presence moves metrics.
When social workers provide emotional grounding, clarity, and support during end-of-life care, it shapes what families say on these surveys and what the system decides to fund.
The most human moments generate the most value. But if they go uncounted, they go unfunded. If they go unfunded, they go eliminated.
This is the invisible crisis:
Value Translation
If we want care to stay human, we have to translate human work into the language of value.
That means:
Because dignity and data are not opposites.
When we connect them, we don’t just validate care work. We protect it.
I know what you're thinking:
"You were part of a team. You did your job. How can you prove the value was directly tied to you?"
Fair. But it wasn't just one. I showed up for 20-30 families a week (just like thousands of social workers do) for over ten years across various care settings in three different states.
It’s more like pattern recognition.
And while that's not lab-grade attribution.
It’s common sense, backed by data.
"But you can’t put a price on presence. And trying to do so feels like selling your soul!"
I hear you. ROI is not commodifying compassion. It’s protecting the labor that keeps care human.
It boils down to one simple equation :
Visibility = funding = protection
"I don’t want to mess up the math. I’m not a finance person."
You don’t need a finance degree. You need a simple framework that converts entry points into systems-level proof.
"This is great, but I’m not sure it applies to my setting."
My story is the spark. But I’ve built a replicable, scalable model for any setting where human presence is undervalued and over-relied on.
I'm hosting a free event where I'll breakdown:
Updated August 5, 2025: This post was edited to clarify that while the CAHPS Hospice Survey is not part of Medicare Advantage Star Ratings, its domains reflect system priorities tied to downstream value, experience measures, and plan decision-making.