Innovative Health System Models Of High Value Palliative Care Delivery (TH328)

Abstract

1.Describe a model of advanced illness management for patients with serious illness in a large healthcare system.2.Discuss areas of financial alignment (ie, sweet spot) for palliative care delivery in an accountable care organization or capitated environment.3.Describe the quality and financial impact of care transitions for medically complex elderly patients. Successful integration of palliative care across health systems is increasingly important in the age of healthcare reform and represents a way of both improving quality and reducing costs. Because 5% of Americans account for 50% of healthcare costs, large health systems forming an accountable care organization or those accepting risk contracts are focused on the medically complex and costly population. As reimbursement structures change, palliative care has a major role in keeping patients out of the hospital and reducing costs for those hospitalized. New models of specialist palliative care service delivery, including advanced illness case management, increasing hospice enrollment and length of stay, and outpatient palliative care, are all evidence-based strategies for improving quality and reducing costs for patients that have become a primary focus in the ambulatory setting. In the hospital, palliative care is a demonstrated strategy for reducing costs through transitioning patients out of high-cost settings such as intensive care units, reducing readmissions rates, and more appropriate use of resources. In addition to these clinical strategies, palliative care has a major role to play in population management, identification of “high-risk” patients, and serving as a system-resource for generalist palliative care training and systems initiatives, such as MOLST implementation, advance care planning, system-wide outcomes reporting, and other quality improvement initiatives. This session will describe three successful models of integrated palliative care delivery and population management across various sized healthcare systems. The session will focus on strategies that add value through reliably aligning treatments with patient preferences, deducing costs, and unwanted hospitalizations. The panelists will also openly discuss mistakes and lessons learned in navigating this new terrain. Palliative care leaders must be fluent in the current healthcare reform discussion to have a seat at the table. This session will provide a framework for sound palliative care innovation in health systems.