The Manifest Destinies of Managed Care and Palliative Care

Abstract

Two unremitting forces are shaping changes in the US healthcare system: (1) the graying of America or “silver tsunami,” in which 10,000 individuals are now turning age 65 each day and (2) the cost trends associated with caring for seniors and those with multiple chronic and often life-limiting conditions. Medicare expenditures are crowding out other national priorities and threatening the financial stability of this country. Healthcare experts have identified palliative care and managed care as essential ways to address the special needs of an aging population and for providing care that can lower the rate of national health expenditures. This chapter will review the 30-year history of efforts to demonstrate the inherent synergies of MCOs and palliative care which have driven their conjoint destinies. As important, this collaboration has also shown that effective palliative care interventions can reduce MCO costs and secure a foundation for palliative care program funding.