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Adopt a bundled payment model for home-based and outpatient palliative care.
Integrate palliative care across all lines of business, in all settings, and with other medical and social services frequently used by people with serious illness.
Health plans can enhance access to high-quality serious illness care and optimize the appropriate utilization of existing services by providing palliative care across lines of business. This integration should also span a care continuum that includes home-based primary care, care management, disease management, as well as incorporating outpatient clinics where individuals with serious illness, like those in oncology clinics, already receive care.
Facilitating collaboration among these services enables patients to transition seamlessly to the support that aligns with their evolving needs, reducing the risk of both over-and under-serving patients. This approach also fosters improved coordination among treating providers and establishes palliative care as the standard of care for people with serious illness.
INTEGRATION
THE ESSENTIALS
At the very least, start here
PROGRESSING FURTHER
Take the next steps
SETTING THE STANDARD
Strive for excellence
Action Items
At the very least, start here
A. Within the plan: Offer palliative care across all lines of business and foster connections between palliative care and aligned plan programs.
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Offer palliative care across all plan of business.
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Share palliative care infrastructure, staff, and educational programs across lines of business, to promote consistency and efficiency.
B. Across the provider network: Promote integration of palliative care into aligned medical services and support collaboration between palliative care providers and the network of medical and social services used by seriously ill members.
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Ensure network capacity to offer palliative care in all settings where seriously ill members seek care, leveraging both in-person and telephone or video visits.
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When necessary, mentor and support organizations that are newer to delivering palliative care and encourage collaboration between newer and more experienced providers in the network.
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Use contracting requirements and incentives to encourage the integration of palliative care into other inpatient, outpatient, and home-based services that are used by seriously ill members. For example, offer a bundled payment for outpatient oncology visits if the care model includes palliative providers.
Report
Recommendations for Integrating Palliative Care Capabilities and Specialists into Population-Based Models (Center to Advance Palliative Care)
Example actions for building palliative care capabilities at the payer level and among network providers.
Case Study
Embedded RN-Led Clinics in Primary Care Practices (Center to Advance Palliative Care)
Example of embedding palliative care with another clinic service.
Webinar
The Intersection of CalAIM and Palliative Care (MCP Palliative Care Learning Community Webinar)
Review of how palliative care intersects with Medi-Cal transformation.