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Adopt a bundled payment model for home-based and outpatient palliative care.


Adopt a bundled payment model for home-based and outpatient palliative care.

Payers should adopt a bundled payment model for home-based and outpatient palliative care. In a bundled payment model, a single payment covers the delivery of a specified set of services, by a multidisciplinary team, over a defined period of time. Bundled payments create incentives for delivering the optimal palliative care model, making it feasible and sustainable for providers to offer high-quality palliative care. In contrast, fee-for-service payment models do not cover the cost of the full interdisciplinary team, including nurses, chaplains, care navigators, social workers, or the extensive coordination activities required to deliver services.

A 2023 survey of Medi-Cal managed care plans conducted by the Coalition for Compassionate Care of California found that 67% of the 14 responding plans reported using a bundled payment model for home-based palliative care.* Furthermore, the Consensus Standards for Community-Based Palliative Care in California (including home and outpatient palliative care), which were developed by a collaborative of health plans, provider organizations and health services researchers, also endorse bundled payments as the preferred payment model.**


At the very least, start here


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Action Items

At the very least, start here

Adopt a bundled payment model that covers the effort of the entire interdisciplinary team needed to deliver all specified outpatient and home-based palliative care services across lines of business and markets.

Compensate palliative care providers for initial assessments, irrespective of whether patients ultimately enroll.


Palliative Care in Medicaid Costing Out the Benefit: Actuarial Analysis of Medicaid Experience (National Academy for State Health Policy)

​Guidance on how to price a bundled payment.


Home-Based Palliative Care Payment and Delivery Models for Short-Term Interventions (Center to Advance Palliative Care)

Guidance on payment approaches for short-term palliative care needs, such as during a transition to home after hospital, hospice, or to another care team.


2023 survey of MCPs and palliative care providers (Coalition for Compassionate Care of California)

Survey of 14 Medi-Cal managed care plans (MCPs); includes a question regarding payment mechanisms used for home-based palliative care. 


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