By Les Masterson
- Hospitals are increasingly turning to palliative care programs as a way to offer value-based end-of-life care, according to a report in Health Affairs.
- Hospitals with more than 50 beds offering palliative programs tripled between 2000 and 2015 from 25% to 75%. In 2015, more than 90% of hospitals with 300 beds and 100% of the National Cancer Institute’s Comprehensive Cancer Centers had palliative care services.
- The Center to Advance Palliative Care (CAPC), with its training program, the Palliative Care Leadership Centers, is an example of an organization working to expand palliative care. Of the more than 1,240 hospital palliative care teams that trained at the center, 80% of them instituted palliative care within two years.
The move into palliative care is counter to healthcare systems looking to “profit centers” that generate new revenue. Instead, clinician-leaders have moved toward palliative services “to improve the quality of life and outcomes for patients with serious illness and their families,” according to the report.
Palliative care is a “high-touch, relationship-driven approach,” which can benefit in the areas of “improved quality, patient and family experience and use of healthcare resources.” Though palliative care has shown successes, the report said there are still barriers to wider adoption, such as no dedicated funding source and the cost of interdisciplinary teams exceeding fee-for-service revenue.
Healthcare continues to move into a value-based model, which will benefit palliative care. Payers increasingly want to reimburse providers for caring for patients, improving outcomes and lowering costs instead of for how many services they provide and tests they order. An important aspect of palliative care is listening to patients who may not want to pursue aggressive treatment tactics, and value-based models can take this into consideration.
There are huge costs associated with end-of-life care. The last year of life accounts for about one-quarter of Medicare dollars, which are spent on in-patient care, post-acute care and hospice. However, hospitals are increasingly using palliative care teams to reduce avoidable costs and provide end-of-life care that patients want.
“Palliative care teams are able to pull everyone together into the same room — not only the family but also the many different sub-specialists — and actually have a conversation about what is medically appropriate for this patient, so that the care plan becomes rational and appropriate,” CAPC Director Diane Meier told Healthcare Dive last year.
Palliative care has gotten attention beyond healthcare. Google led a $32 million funding round for Aspire Health, a Nashville-based palliative care provider, in 2016.