The field of palliative care has made tremendous strides over the past decade, with expanded access to services across settings and expanded payment mechanisms through Medicaid managed care plans and other commercial or Medicare plans. Health care leaders are realizing that palliative care improves health outcomes and quality of life while reducing the overall cost of care.
This toolkit provides essential information and resources to assist health plan champions in creating or advancing a palliative care program.
HEALTH PLAN ACCELERATOR FOR PALLIATIVE CARE:
A TOOLKIT FOR INTERNAL CHAMPIONS
The toolkit is divided into three sections:
HOW TO USE THIS TOOLKIT
BACKGROUND
"The Health Plan Accelerator for Palliative Care" (The Accelerator) is part of a broader initiative, funded by the California Health Care Foundation (CHCF), to identify and disseminate actionable opportunities for advancing palliative care over the next 5-10 years. In discussions that informed this initiative, many members of the palliative care movement emphasized that the field of palliative care is at an inflection point in its growth. While specialty palliative care is available in most acute care hospitals, there remains a significant gap in the availability and use of outpatient and home-based palliative care. Acknowledging the vital role that health plans play in expanding equitable and high-quality palliative care, The Health Plan Accelerator was developed by Transforming Care Partners to assist internal champions at health plans in advocating for, developing the business case for, and formulating a plan to further advance palliative care.
The Accelerator serves as a companion to another CHCF resource, “California’s Palliative Care Evolution: Celebrating Progress and Shaping the Future”, also developed by Transforming Care Partners. In contrast to the Accelerator, which is tailored specifically for health plans, that resource is designed for leaders representing multiple sectors. These leaders, including those from health systems, providers, community-based organizations, policy makers, government agencies, and membership organizations, all play a role in advancing palliative care. In addition to identifying the drivers of progress in California, that resource highlights eight opportunities and potential actions to further advance palliative care over the next 5-10 years.
ACKNOWLEDGMENTS
Transforming Care Partners would like to extend gratitude and appreciation to the people (listed below) interviewed for this resource, as well as those who provided valuable reviews of early drafts. In generously sharing their time, experiences, and insights, they helped identify feasible and meaningful opportunities for health plans to improve the quality of care delivered to seriously ill members.
Kim Beverly, MSW, MSG
Palliative Care Clinical Program Manager
Blue Shield of California
Brynn Bowman, MPA
Chief Executive Officer, Center to Advance Palliative Care (CAPC); Assistant Professor Brookdale Department of Geriatrics and Palliative Medicine
Ichan School of Medicine at Mount Sinai
Kimberly Bower, MD
Medical Director
Blue Shield of California
James Cotter, MD, MPH
Associate Medical Director, Health Services Department
Partnership Healthplan of California
Mercy Kagoda, MD, MPH
Medical Director of Care Management
Inland Empire Health Plan
Will Kennedy, DO
Palliative Care Physician and Medical Director
CareOregon
Blanca Martinez, MSW, CCM
Director of Case Management
Molina Healthcare
Kate Meyers, MPP
Senior Program Officer
California Health Care Foundation
Robert Moore, MD, MPH
Chief Medical Officer
Partnership Healthplan of California
Tom von Sternberg, MD
Medical Director SNP, Medicare, and Care Management
HealthPartners
Susan Stone, MD, MPH
Senior Medical Director
L.A. Care Health Plan
Susan Elizabeth Wang, MD
National Medical Director, Dignified Journeys & Palliative Care; SCAL Chief, Geriatrics & Palliative Medicine
Kaiser Permanente