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Monday Memo
Monday Memo
Monday, February 15, 2016
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Palliative Care Conversation Expands

Health insurers are increasingly targeting palliative care in their ongoing mission to improve quality and bring down costs associated with the most expensive aspects of care, partnering with specialty providers and launching pilot programs aimed at the terminally ill.

On Jan. 1, CMS began reimbursing physicians for conducting end-of-life conversations with their patients, a provision proposed for inclusion in the Affordable Care Act for 2009. The new billing code encourages advanced care planning and would allow the government to track how much time doctors spend discussing a patient's care goals and final wishes.

Insurance companies are recognizing that there is economic value associated with their Advanced Services program including decreased hospitalizations and increased hospice utilization. The savings more than covers the cost of paying physicians to have advanced care planning conversations with their patients.

[AIS Health, January 11, 2016]

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Tips from our featured course

Palliative Care: A Consultative Service
with Longitudinal Follow-up

Palliative care differs from hospice care in that patients are allowed to simultaneously receive any and all medical treatment which is deemed to be potentially effective medical treatment directed toward their underlying disease(s).

Palliative care was not set up as an independent health care benefit, but as an independent health care benefit through a limited consultative supplement to standard medical and surgical treatments.

While palliative care was initially started as a hospital-based consultative service, it is increasingly expanding as an outpatient and home-based service with longitudinal follow-up.

[Palliative and End-of-Life Care, Module B, Economics, Regulations and Reimbursement]

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Palliative Care: Moving Beyond Unrealistic Expectations

In palliative care the term "false hope" is used in cases where a patient's treatment goals are so unrealistic that embracing those goals results in suffering for both the patient and family including:

  • Pain
  • Psychological stress
  • Financial burdens

Transdisciplinary palliative care teams help patients and family members to identify realistic goals of care and select treatment options that meet those goals. An integral part of this in which case managers fulfill an essential role is in supporting smooth transitions of care and discharge options.

[Palliative and End-of-Life Care, Module E, Patient Goals and Expectations]

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