Palliative Care Who-What-When- Where-How-Why Made Easy
|
|
- Thomas Bridges
- 5 years ago
- Views:
Transcription
1 NAHC 2014 Annual Meeting & Exposition October 2014 Session 613 Thinking Outside the Box of Medicare Hospice/Home Health: Palliative Care and Advanced Illness Management Sharyl Kooyer, Sutter Care at Home Bill Musick, The Corridor Group Robert Parker, PRIME by AseraCare Palliative Care Who-What-When- Where-How-Why Why Made Easy Overview INTRODUCTION 2 1
2 Objectives 3 Flow 1. Context: Models and Issues 2. Specific Case Studies PRIME (Progressive Illness Management Expertise) by AseraCare Advanced Illness Management Program Sutter Care at Home 3. Q&A 4 2
3 Caveats If you ve seen one palliative care program, you ve seen one palliative care program. one palliative care program. Regulations vary by state and by payer and are continually evolving please don t take our comments as legal advice Beware of relying too much upon someone else s experience 5 Questions in the room 6 3
4 Palliative Care Models CONTEXT 7 What? Advanced Illness Management Death Manageable, early, stable conditions Serious, progressive conditions that limit daily activities Palliative Care Hospice Care Bereavement Support Diagnosis of Life-threatening or Debilitating Illness or Injury Disease Progression Terminal Phase of Illness 8 4
5 What is Palliative Care? Center to Advance Palliative Care (CAPC) Specializedcare care for peoplewith seriousillnessesillnesses Focused on relief from the symptoms, pain, and stress of a serious illness goal is to improve quality of life for both the patient and the family provided by a team of doctors, nurses and other specialists who provide an extra layerofsupportat at any age andatat anystagein a serious illness and can be provided along with curative treatment support patient and family, not only by controlling symptoms, but also by helping to understand treatment options and goals 9 What is Palliative Care? Center to Advance Palliative Care (CAPC) The palliative care team provides: Expert management of pain and other symptoms Emotional and spiritual support Close communication Help navigating the healthcare system Guidance with difficult and complex treatment choices 10 5
6 Variations Setting Acute Specialty/ General Clinics Skilled Nursing Primary Care Hospice Home Health Task specific (Advanced Directives vs P&SM) Disease specific (Cancer vs CHF) Symptom specific (Pain) Delivery method (Face to face, telephonic, video) 11 Palliative Care HOW TO MAKE MONEY BREAK EVEN GET PAID 12 6
7 Payment Billable Entitlement Programs Medicare Part B Physician/NP LCSW (using mental billing codes only) Home Health Concurrent Hospice Care Revenue Cost Medicaid Pediatric Concurrent Care Commercial Insurers CMS Demonstration Project?? 13 Payment (continued) Entrepreneurial Contracts Commercial Insurer Hospital/Health System Innovation Award/ACO/Bundled Payment Philanthropic Research Foundations Private Pay Fee for Service (Concierge) 14 7
8 Cost Avoidance in Lieu of Payment System-wide Cost Savings/ Outcomes Net Investment in Palliative Care 15 * * Palliative Care WHO and WHY 16 8
9 Why? Service Goals Unmet need Move upstream Discharge option Financial Goals Loss is OK (at least to start) Break even Financial contribution 17 Who? All with need Top potential for savings Segmented population Highest Cost Disease Management Pre/Post Hospice 18 9
10 Palliative Care Examples of Delivery Models 19 Examples: Advance Care Planning Gundersen Health System s Respecting Choices Program 20 10
11 Example: UPHS CLAIM Project University of Pennsylvania Health System CLAIM Project (ComprehensiveLongitudinal AdvancedIllness Management) Home Health based program with supplemental disciplines Cancer Goal: reduce unnecessary end of life care costs and decreased quality of life Seed funding: Health Care Innovation Awards Long term: Cost avoidance, outcome improvements 21 Example: Lehigh Valley Health Network Optimizing Advanced Complex Illness Support (OACIS) Three pronged service OACIS Home Based Consult Service OACIS/Palliative Medicine Inpatient Consult Service Palliative Care Outpatient Clinic (PCOC) Cancer Center Medical Director, APNs, RN Case Manager Cost avoidance/improved outcomes 22 11
12 Examples: Entrepreneurial Services Contractual arrangements by hospices/home health agenciesto provide a combination of: Billable physician/np services with Hospital payment for social work/chaplain and/or physician/np administrative time Palliative care providers at risk for achieving savings through identification and care of high cost chronic care patients (insurer or health system, ACO) 23 Comments/questions 24 12
13 Case Study PRIME by ASERACARE 25 History Program Development: Due diligence 18 months ( ) Identity PRIME by AseraCare What Services NP Consultative Medical Model NP Skilled Nurse Facility Primary Care Service Model NP Payer Medical Case Management Model 26 13
14 History Program Expansion: Community based NP 16 programs in 9 states Skilled Nursing Facility 5 programs in 3 states 10 programs in development Payer Medical Case Management 1 Managed Medicaid payer ACO, palliative outpatient clinics, hospital system partnership opportunities 27 Why Poor Transitional Care Care Silos Acute Skilled Nursing Facility Commercial/Managed Care Payers Physician/Physician Groups Community at Large 28 14
15 PRIME by AseraCare Four Pillars: Pain and Symptom Management Medication Management Setting Management Advance Care Planning 29 PRIME by AseraCare Core Staff: Advanced Practice Registered Nurse (APRN) Provider H&P Board Certified MD Collaborative Physician i Licensed Clinical Social Worker (LCSW) DSM diagnoses 30 15
16 PRIME by AseraCare Framework: Pti Patient caregiver t i Care Continuum Communication and Collaboration Healthcare Systems PCPs SNFs and SNF Attending Home Health lthagencies Other care settings NP as Community Case Manager 31 PRIME by AseraCare NP Community Model: Across all settings Seriously ill patients with progressive illness High risk for futile care End stage disease trajectory 1+ years out from being clinically eligible for Hospice 32 16
17 NP Community Model 33 PRIME by AseraCare NP SNF Model: Dedicated to individual SNF Chronically/Seriously ill patients Rehab to Home 2+ years out from being clinically eligible for Hospice Periods of decline and stabilization Potential for high risk of futile care Plus end stage disease trajectory 34 17
18 NP SNF Model 35 PRIME by AseraCare NP Payer Model: NP Medical Case Management Life altering, life limiting care needs 4+ years up stream from being clinically eligible for Hospice Focus on high utilization of resources Patient self management focus Risk stratified cost avoidance 36 18
19 NP Payer Model 37 Statistics Practice: Initial/New Consults 2664 (program to date July 31) Total Consults 10,128 (program to date July 31) Hospice Conversions 666 patients (program to date July 31) 25% conversion rate (program to date) 30% conversion rate (YTD 2014) 38 19
20 Statistics Quality: Pain 94% on a goal of 80% Dyspnea 99% on a goal of 70% Anxiety 98% on a goal of 70% Goals of Care 98% on a goal of 100% Re hospitalization 1.3% on a goal of <5% 39 Financial Reimbursement constraints: Fee for service Payer Gaps in knowledge: Consumer confusion Industry confusion 40 20
21 Financial Revenue: Break even model Proforma builds month over month Break even within 12 months SNF model Easier model to break even Consolidated patient set 41 Financial Revenue: Community consults per month Initial/New Subsequent/Established SNF consults per month 60 Initial 240 Subsequent 42 21
22 Financial Revenue: Evaluation & Management CPT Coding All three services lines Payer model additional revenue through gain sharing Negative margin before hospice conversion Other risk share, PMPM 43 Comments/questions 44 22
23 Sutter Health / Sutter Care at Home Advanced Illness Management (AIM ) A Model for Palliative Care and Complex Care Management 45 Health Care Innovations Awards Sutter Care at Home Advanced d Illness Management The project described was supported by Grant Number 1C1CMS from the Department of Health and Human Services, Centers for Medicare & Medicaid Services. "The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies." 46 23
24 THE AIM JOURNEY: 2008 PRESENT Imperative for AIM Model Design Characteristics Person Centered Care Identified the gap/burden in care Secure funding Research and design Evaluated pilot; decided on system wide implementation Implementation planning Conduct pilot System Integration ti Launch readiness planning Site implementation Infrastructure development Impact on Care Outcomes AIM Program Model : Better Health Better Care Lower Cost Program evaluationsystem & payer Continuous program development, improvement, maturing 47 "The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies." The AIM Patient Experience Additional Statistics Medicare will spend 28% of all their payments on a patient in the last year of life Medicare will spend ~$214M per year for 5,000 patients in the last year of life Patients have a 25% chance of receiving hospice care where they will spend 8 days on service before dying Patients in the last year of their lives represent 5% of the population that spends the highest amount of Medicare dollars and take the most time and resources from providers Source: Data of Sutter Experience The Care of Patients with Severe Chronic Illness. Dartmouth Atlas, 2006 The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies
25 SYSTEM FRAGMENTATION SYSTEM INTEGRATION HOSPITALS Emergency Dept. Hospitalists Inpatient palliative care Case managers Discharge planners AIM Care Liaisons MEDICAL OFFICES Physicians Office staff Care managers Telesupport 911 HOME-BASED SERVICES Home health h Hospice Transitions Team Telesupport CRITICAL EVENTS Acute exacerbation Pain crisis Family anxiety New AIM staff & services 49 The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies. AIM MODEL DESIGN CHARACTERISTICS Target Population > 2 Chronic Illnesses; >1 Illness Advancing Poly pharmacy Clinical, Functional, and/or Nutritional Decline High Symptom Burden leading to repeat utilization MD Surprise Question 12 Months Model Principles Personal Goals Person &Physician Relationship Central Dual Therapeutic Approach Curative + Palliative Evidenced Based Clinical Care and Care Management Simplify and Drive Communication Pillars of Care Advanced Care Plans Self Management Plan of Red Flag Symptoms Medication Management Ongoing Follow Up Visits Engagement & Self Management Support Resting on Curative + Palliative Care Foundation Drivers of Outcome Aware and Skilled in Health Literacy & Patient Engagement Continue During Periods of Illness and Wellness, across all settings Frequent & Predictable MD Communication Teams Without Borders 50 The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies. 25
26 PERSON CENTERED CARE Clinician Patient/ Family Teach Back Bubble Diagrams Chunk and Check Motivational Interviewing Stop Light Forms SMART Goals Evidence-based Care Medication Management Management POLST Evidence-based Palliative Care Mock Runs Personal Health Record 51 The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies. CLOSER LOOK AT INTEGRATION 52 The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies. 26
27 STAFFING MODEL AIM Team Members AIM Home Health (HH RNs, MSWs, plus other disciplines) AIM Hospital Based (AIM Care Liaison, RN, former Hospice) AIM Team AIM Transitions (former Hospice RNS and MSWs) AIM Telesupport/ Office Based Case Management (RN mixed experience) Case Loads AIM Home Health:13 17 pts AIM Transitions: 15 20pts AIM Telesupport: 60 80pts Medical Director:.2.3 FTE AIM Administrator (also Hospice Administrator) Leadership Team=HH, Hospice, AIM 53 The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies. AIM: TOTAL COST OF CARE Hospital Home Health (AIM) Total Cost of Care Physician AIM Telesupport/ Office Based Case Management AIM Transitions 54 The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies. 27
28 Examples of AIM Measures Care at the End of Life Outcomes, Resources and Costs % Transferred to Hospice Inpatient and ED visit Rates per 100 patients % Died in Hospital 30, 90 and 180 Day Pre/Post Hospital Days in Last 6 months Enrollment Utilization of life Hospital ED Ed Use in Last 30 Days of Life ICU ALOS in Hospice ICU Use in Last 30 Days of Life 90 Day Payer Impact, Hospital LOS of Hospice Stay Cost Impact, Total Cost of Care Independent Research and Evaluation 55 The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies. Closer Look at Care Integration 56 The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies. 28
29 Improving Health IMPACT ON CARE Improving Care Lowering Cost Change in Utilization 90 Days Post AIM Enrollment 9 of 10 sites reporting; Q Q1 2014); n 1544 (Results not yet confirmed independently by CMS Evaluators) Now serving 15 counties; enrolled more than 6,500 persons with advanced illness; 335 staff members trained Current census is 2100+; 85,000 patient contacts last 12 months CMS awarded Sutter with a $13 million Innovation Challenge grant to fund the ongoing implementation and evaluation of the AIM program; Sutter provided $21.4 M Cha ange in Utilization % Reduction 19% Reduction 67% Reduction Pre Post Ongoing high patient and provider satisfaction. 0 Hospitalizations ED Visit ICU Days Service Utilization 57 The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies. Interim Results: 90 Day Pre/Post Cost Analysis 12 Months Rolling Q Q Out of 10 Sites Reporting (Results not yet confirmed independently by CMS Evaluators) Cost of Care Impact (N=1,544) $15,417,246 $16,400, $12,799,460 $0 $2,000,000 $0 Cost of Care Impact Per Enrollee (N=1,544) $9,985 $10,622 $8,290 $4,000,000 $6,000,000 $8,000,000 $10,000,000 $2,000 $4,000 $6,000 $12,000,000 $14,000,000 $16,000,000 Change in Total Sutter Costs $8,000 $10,000 Change in Total Sutter Costs $18,000,000 Change in Net Charges Billed to Payers Change in Hospital Costs $12,000 Change in Net Charges Billed to Payers Change in Hospital Costs 58 The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies. 29
30 CHALLENGES Time required to adopt and hardwire new clinical and care management skills Regulatory & legal environment not aligned with health care reform innovation Expanding Access to AIM Services and Evaluating the Model of Care Immediate demand for clinical, operation, and financial integration outpaced IS infrastructure Resources and skills to perform specialty analytics in timely, consistent and reliable manner 59 The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies. OPPORTUNITIES Investment in infrastructure for broader complex care management Participate in design or evaluation of model of care for persons with advanced illness Develop new payment model to serve this complex growing population of patients 60 The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies. 30
31 living in two worlds at the same time is challenging Fee For Service Value Based Population Reimbursement 61 The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies. 62 The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies. 31
32 Health Care Innovations Awards The project described was supported by Grant Number 1C1CMS from the Department of Health and Human Services, Centers for Medicare & Medicaid Services. 63 The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies. Resources What is Palliative Care?, Center to Advance Palliative Care, Palliative Care Services: Solutions for Better Patient Care and Today s Health Care Delivery Challenges, American Hospital Association, November 2012, HPOE/palliative_care_services_solutions_bet ter_patient_care.pdf Hospice and Palliative i Mdii Medicine: What Are the Next Steps for a Match (National Resident Matching Program) (2012) Signer
33 Resources University of Pennsylvania School of Medicine. "Care At The End Of Life: Room For Improvement, Ideas For Change." Medical News Today. MediLexicon, Intl., 23 May Web. 12 Aug Palliative Care and Hospice Care Across the Continuum, Center to Advance Palliative Care, care across the continuum/ Improving Care for People with Serious Illness through Innovative Payer Provider Partnerships, Center to Advance Palliative Care, 65 Contact Information Sharyl Kooyer AIM Program Director, Sutter Care at Home (916) Bill Musick Senior Associate, The Corridor Group (888) (toll free) Robert Parker Program Manager, PRIME by AseraCare (512)
34 Comments/questions 67 Compare & Contrast Targeting and Triggers* Interdisciplinary Team Composition* 24/7 Clinical Response * Integrated Medical and Social Supports* Concurrent Care* Setting Specific or Agnostic? * CAPC Essential Structural Characteristics of High-Value Palliative Care 68 34
35 Palliative Care PLANNING AND DEVELOPMENT CONSIDERATIONS 69 Issues in Financial Viability Incomplete payment mechanisms Optimal utilization of high cost providers Over extending services Services provided d Patients served 70 35
36 Tips Focus on local needs Assess local resources Look for creative leveraging of community resources When possible, shoot bullets first, then cannon bll balls 71 Tips (continued) Think outside of legacy models Trust and compatible culture of partners ranked higher than logistics/systems by hospital executives Value of practice management 72 36
37 Palliative Care Models Tips and Considerations from the Field 73 Resources & Acknowledgements Center to Advance Palliative Care Palliative Care Center of the Bluegrass (Hospice of the Bluegrass) Gretchen Brown, CEO 1 of 8 CAPC Palliative Care Leadership Centers (PCLCs) Physician practice model providing services in academic and community hospitals, NFs and outpatient clinic 74 37
38 Tips from the field On Start up and Partnering Pay attention to resistance it may be well founded and deserve further analysis No one knows what you will and will not do as a palliative care provider tell them Don t claim outcomes (cost avoidance, readmission rates, patient/family satisfaction) without having documentation to prove it Your partner does not care/believe in cost avoidance findings from other providers saying it louder won t help 75 Tips from the field Especially for hospice providers Avoid palliative care as hospice light it is exactly as it sounds less and not as good as should be expected Having the same provider offer both hospice and palliative care services contributes to the confusion Providers and consumers do not understand palliative care or hospice saying one is not the other is not a clarification 76 38
39 Tips from the field Diversify funding resources: Learn or buy Part B billing expertise; obtain the necessary provider numbers; be sure to have all your ducks in a row Train clinicians to bill effectively and collect early and often they will hate the first part and like the second Fund raise shamelessly it s a skill set we already own 77 Tips from the field Courtesy of Palliative Care Center of the Bluegrass Physicians Remember that MDs are your most expensive staff, followed closely by NPs Set high expectations for productivity (8 10+ visits/day) MDs are your best marketers for PC Use NPs in NFs to extend MDs 78 39
40 Tips from the field Courtesy of Palliative Care Center of the Bluegrass Payment Do not expect PC to generate a profit Do bill Part B and do it well (attention to accuracy and coding) Don t give away PC get a fair payment from hospitals Require hospital partners to measure the impact of PC 79 Tips from the field Courtesy of Palliative Care Center of the Bluegrass Other Think twice about offering palliative home care Don t provide PC to hospice patients or most of your discharged hospice patients 80 40
Transitional Care With Palliative Medicine
Bridging The Gaps: Providing Transitional Care With Palliative Medicine Angie Hollis-Sells, RN, CHPN President AseraCare Robert Parker, RN, MSN Ed., CHPN Program Manager Bridging The Gaps: Proving Transitional
More informationSession 304: How to Integrate Palliative Care Into Your Community-based Home Health and Hospice Programs
Session 304: How to Integrate Palliative Care Into Your Community-based Home Health and Hospice Programs Bob Parker, RN, MSN, CENP, CHPN Corporate Director of Palliative Care Interim Healthcare Objectives
More informationAdvocate Health Care Palliative Care Service Line
Advocate Health Care Palliative Care Service Line Making the case for Palliative Care Approximately 90 million Americans are living with serious and life-threatening illness, and this number is expected
More informationThe Changing Landscape of Palliative Care
The Changing Landscape of Palliative Care KAHPC 17th Annual Conference August 2015 Brian Jones Joe Rotella Elizabeth Wessels Turner West Kay Williams Why Home-based Palliative Care? Turner West, MPH, MTS
More informationPalliative Care and Hospice in an Accountable Care Model. Key Strategies to a Successful Integrated Delivery System
Palliative Care and Hospice in an Accountable Care Model Key Strategies to a Successful Integrated Delivery System Monique Reese DNP, ARNP, FNP-C, ACHPN Lori Bishop RN, CHPN Objectives Describe the formation
More informationIn this monthly feature, NewsLine
In this monthly feature, NewsLine shines the light on a hospice organization which has expanded services or has partnered with other community organizations to reach patients earlier in the illness trajectory
More informationMember-centered cancer care In Georgia
Quality health plans & benefits Healthier living Financial well-being Intelligent solutions Member-centered cancer care In Georgia Ira Klein, MD, MBA, FACP GASCO Annual Meeting September 5, 2015 > One
More informationPalliative Care: A Business Analysis of the Pros and Cons of Establishing a Palliative Care Program
1 Palliative Care: A Business Analysis of the Pros and Cons of Establishing a Palliative Care Program Daniel Maison, MD Larry Oberst, CPA Spectrum Health 2 Faculty Information Daniel Maison, MD FAAHPM
More informationFoundations in Community-Based Palliative Care Essential Elements for Success
Foundations in Community-Based Palliative Care Essential Elements for Success Presented by Russell K Portenoy MD Foundations in Community-Based Palliative Care Essential Elements for Success Russell K
More informationBilling and Payment Models for Palliative Care
Billing and Payment Models for Palliative Care Liz Fowler, MPH President and CEO Bluegrass Care Navigators October 15, 2017 Tom Gualtieri-Reed, MBA Partner, Spragens & Associates Consultant, Center to
More informationReadmission Strategies: Palliative Care as a Piece of the Puzzle
Readmission Strategies: Palliative Care as a Piece of the Puzzle Virginia Hospital and Healthcare Association Webinar May 23, 2014 L y n n H i l l S p r a g e n s, M B A P r e s i d e n t, S p r a g e
More informationHospice and Palliative Care An Essential Component of the Aging Services Network
Hospice and Palliative Care An Essential Component of the Aging Services Network Howard Tuch, MD, MS American Academy of Hospice and Palliative Medicine Physician Advocate, American Academy of Hospice
More informationc i r c l e o f l i f e a w a r d C I R C L E o f L I F E
circle of life award 2017 The 2017 awards are supported, in part, by the California Health Care Foundation, based in Oakland, California, and Cambia Health Foundation, based in Portland, Oregon. Major
More informationSession 127 PD - Palliative Care: Improving Quality While Lowering Cost. Moderator: Allison Silvers
Session 127 PD - Palliative Care: Improving Quality While Lowering Cost Moderator: Allison Silvers Presenters: Torrie Fields Stan Hornbacher Allison Silvers SOA Antitrust Compliance Guidelines SOA Presentation
More informationObjectives. ORC Definition. Definitions of Palliative Care. CMS and National Quality Forum Definition (2013) CAPC 9/7/2017
Objectives General overview of palliative care Define the role of palliative care Palliative Care Management and Transition Joan Hanson, Director of WRN Palliative Care, RN, CHPCA Jennifer Martnick, Team
More informationHow to Integrate Peer Support & Navigation into Care Delivery
How to Integrate Peer Support & Navigation into Care Delivery Andrew Bertagnolli, PhD Care Management Institute Why Integrate Peer Support into the Care Delivery Pathway? Improved health Increased feelings
More informationPalliative Care Quality Improvement Program (QIP) Measurement Specifications
Palliative Care Quality Improvement Program (QIP) 2017-18 Measurement Specifications Developed by: QIP Team Contact: palliativeqip@partnershiphp.org Published on: October 6, 2017 Table of Contents Program
More informationPalliative Care in the Community Setting. David Mandelbaum, MD Melissa Rockhill, MSN, GNP-BC Lorie Hacker, MSN, NP-C, CNE
Palliative Care in the Community Setting David Mandelbaum, MD Melissa Rockhill, MSN, GNP-BC Lorie Hacker, MSN, NP-C, CNE Objectives 1. Discuss the framework for building a palliative care program in the
More information9/18/2018. Reforming Care Beyond Healthcare: Opportunities & Challenges for True Palliative Care. Perspectives
Midwest Conference on Palliative & End of Life Care Palliative Care Pre-Conference Kansas City, Missouri October 2018 Reforming Care Beyond Healthcare: Opportunities & Challenges for True Palliative Care
More informationStudy of Hospice-Hospital Collaborations
Study of Hospice-Hospital Collaborations Table of Contents Executive Summary 2 Introduction 3 Methodology 4 Results 6 Conclusion..17 2 Executive Summary A growing number of Americans in the hospital setting
More informationSENATE AND ASSEMBLY HEARING ON THE EXECUTIVE HEALTH BUDGET PROPOSAL
2017-2018 SENATE AND ASSEMBLY HEARING ON THE EXECUTIVE HEALTH BUDGET PROPOSAL February 16, 2017 Testimony from the Hospice and Palliative Care Association of New York State Introduction The Hospice and
More informationPalliative Care to Hospice: Forging an Effective Partnership. Dennis Cox, LCSW
Palliative Care to Hospice: Forging an Effective Partnership Dennis Cox, LCSW The Old Days Home Care or Hospice There was a clear choice Physicians needed to take a stand Have the Hospice conversation
More informationCenter to Advance Palliative Care:
Center to Advance Palliative Care: Transforming the Care of Serious Illness Diane E. Meier, MD 26 April 2018 Presentation to The Netherlands Palliative Care Quality Congress What is Palliative Care? A
More informationWHAT DOES IT TAKE TO SCALE HOME-BASED PALLIATIVE CARE?
WHAT DOES IT TAKE TO SCALE HOME-BASED PALLIATIVE CARE? LESSONS LEARNED (SO FAR) FROM AN IMPLEMENTATION EVALUATION OF THE ROLLOUT OUT OF HBPC IN THE BAY AREA Gary Bacher, JD/MPA, Founding Member, Healthsperien
More informationGUIDE TO PROGRAM DESIGN
GUIDE GUIDE Palliative Care in the Home A GUIDE TO PROGRAM DESIGN PALLIATIVE CARE IN THE HOME: A GUIDE TO PROGRAM DESIGN Table of Contents Section 1 Introduction A Letter from Diane E. Meier, MD B Key
More informationValue of Hospice Benefit to Medicaid Programs
One Pennsylvania Plaza, 38 th Floor New York, NY 10119 Tel 212-279-7166 Fax 212-629-5657 www.milliman.com Value of Hospice Benefit May 2, 2003 Milliman USA, Inc. New York, NY Kate Fitch, RN, MEd, MA Bruce
More informationHospice and Palliative Care: Value-Based Care Near the End of Life
Hospice and Palliative Care: Value-Based Care Near the End of Life Mary Dittrich, MD, FASN Senior Medical Director, Remedy Partners Joseph W. Shega, MD National Medical Director, VITAS Healthcare 2017
More informationPalliative Care: Mission and Strategic Imperative. Sarah E. Hetue Hill, PhD Ascension Healthcare
Palliative Care: Mission and Strategic Imperative Sarah E. Hetue Hill, PhD Ascension Healthcare Ascension Palliative Care Definition Palliative Care is person-centered, holistic care delivered by an interdisciplinary
More informationHospice and Palliative Care: Value-Based Care Near the End of Life
Hospice and Palliative Care: Value-Based Care Near the End of Life Mary Dittrich, MD, FASN Senior Medical Director, Remedy Partners Joseph W. Shega, MD National Medical Director, VITAS Healthcare 2017
More informationExploring the Benefits of Both Palliative and Hospice Care
Exploring the Benefits of Both Palliative and Hospice Care David Mandelbaum, M.D. Director, Palliative Care Services Co-Medical Director, Hospice Services Franciscan Health, Indianapolis, Mooresville,
More informationPalliative Care for Older Adults in the United States
Palliative Care for Older Adults in the United States Nathan Goldstein, MD Associate Professor Hertzberg Palliative Care Institute Brookdale Department of Geriatrics and Palliative Medicine Icahn School
More informationInnovation Summit. November 1, 2018
Innovation Summit November 1, 2018 Financial Disclosures Gabby Cornett, MBA, Jacob Graham, MD and Kristy Johnson-Pich, DO have no financial conflicts of interest to disclose. Home-Based Palliative Care
More informationHEALTHSTREAM LIVING LABS IN ACTION
HEALTHSTREAM LIVING LABS IN ACTION A CONVERSATION WITH: Mitchel T. Heflin MD, MHS Associate Professor of Medicine, Duke University School of Medicine Eleanor McConnell PhD, RN, GCNS-BC Associate Professor,
More informationApproved Care Model for Project 3gi: Integration of Palliative Care into the PCMH Model
1 Approved Care Model for Project 3gi: Integration of Palliative Care into the PCMH Model OneCity Health Webinar January 13, 2016 Overview of presentation 2 Approach to care model development Project overview
More informationRE: Draft CMS Quality Measure Development Plan: Supporting the Transition to the Merit-based Incentive Payment System and Alternative Payment Models
March 1, 2016 Centers for Medicare & Medicaid Services Department of Health and Human Services P.O. Box 8016 Baltimore, MD 21244 Submitted electronically via MACRA-MDP@hsag.com. RE: Draft CMS Quality Measure
More informationEnhancing Care Management with a Palliative Care Partnership
Enhancing Care Management with a Palliative Care Partnership Presented by: Brian Michaelsen, Administrator Family Hospice Care HERITAGE PROVIDER NETWORK HPN is a limited Knox Keene licensed organization
More informationChanging the Face of Palliative Care in Oncology Practice
Changing the Face of Palliative Care in Oncology Practice Karin Porter-Williamson MD Associate Professor of Medicine Medical Director Palliative Care Services KU Hospital Amy Velasquez RN BSN OCN Allen
More informationBranding and Marketing Palliative Care to Spark Earlier Engagement. The Carolina Centers 42nd Annual Hospice & Palliative Care Conference
Branding and Marketing Palliative Care to Spark Stan Massey Partner/Chief Branding Officer Transcend Hospice Marketing Group 42 nd Annual Hospice & Palliative Care September 2018 Charlotte, NC Filled with
More informationPartnership HealthPlan s Implementation of SB Robert Moore, MD MPH MBA. Chief Medical Officer, Partnership HealthPlan of California
Partnership HealthPlan s Implementation of SB 1004 Robert Moore, MD MPH MBA Chief Medical Officer, Partnership HealthPlan of California Medi-Cal Managed Care Model: County Organized Health System Mission:
More informationAchieving earlier entry to hospice care: Issues and strategies. Sonia Lee, APN, GCNS-BC
Achieving earlier entry to hospice care: Issues and strategies Sonia Lee, APN, GCNS-BC Objectives The learner will: Describe the benefits of hospice List at least barriers to early hospice care List at
More informationThere For You. Your Compassionate Guide. World-Class Hospice Care Since 1979
There For You Your Compassionate Guide World-Class Hospice Care Since 1979 What Is Hospice? Hospice is a type of care designed to provide support during an advanced illness. Hospice care focuses on comfort
More informationThe Quality and Value Proposition for Palliative Care in Home Care. Madeline Jacobs, MPA HCA Quality and Technology Symposium November 16, 2017
The Quality and Value Proposition for Palliative Care in Home Care Madeline Jacobs, MPA HCA Quality and Technology Symposium November 16, 2017 Palliative Care Definition Palliative care is specialized
More informationMissouri CCBHC Initiative: Early results show expanded access to care, increased scope of services
Missouri CCBHC Initiative: Early results show expanded access to care, increased scope of services Section 223 of the Protecting Access to Medicare Act of 2014 established a federal definition and criteria
More informationNational Palliative Care Registry : Hospital Palliative Care Preview
National Palliative Care Registry : Hospital Palliative Care Preview Maggie Rogers, MPH Senior Research Associate, CAPC Tamara Dumanovsky, PhD VP Research & Analytics, CAPC September 15, 2016 The National
More informationQuality of Life (F309 End of Life) Interpretive Guidance Investigative Protocol
483.25 Quality of Life (F309 End of Life) Interpretive Guidance Investigative Protocol 2 483.25 End of Life Each resident must receive and the facility must provide the necessary care and services to attain
More informationLeadingAge and Hospice Members: Partners in Providing Quality Care to Older Adults. January 2019
LeadingAge and Hospice Members: Partners in Providing Quality Care to Older Adults January 2019 Hospice is a unique service delivery model providing holistic care to individuals at the end of their lives.
More informationPATH. On the right. Suggested Websites. For Patients with a Serious Illness. PATH is a service provided by:
On the right PATH For Patients with a Serious Illness transitional care for patients with a serious illness Suggested Websites hospicesacredheart.org seriousillness.org/nepa elderlawanswers.com caringinfo.org
More information16 th Annual IHA Stakeholders Meeting Session 2C
16 th Annual IHA Stakeholders Meeting Session 2C September 19, 2017 Hilton Los Angeles Airport Thank you to our Content Partner: Medication Adherence AppleCare Pharmacy Programs Confidential and proprietary.
More informationPalliative Care in the Continuum of Oncologic Management
Palliative Care in the Continuum of Oncologic Management PC in the Routine Continuum of Cancer Care Michael W. Rabow, MD Director, Symptom Management Service Helen Diller Family Comprehensive Cancer Center
More informationCollaboration to Increase the Availability of Palliative Care Services in Illinois Opella Ernest, MD Carol Wilhoit, MD, MS
Collaboration to Increase the Availability of Palliative Care Services in Illinois Opella Ernest, MD Carol Wilhoit, MD, MS A Division of Health Care Service Corporation, a Mutual Legal Reserve Company,
More informationREVIEW AND FREQUENTLY ASKED QUESTIONS (FAQ) 8/5/2015. Outline. Navigating the DSMT Reimbursement Maze in Todays Changing Environment
Patty Telgener RN, MBA, CPC VP of Reimbursement Emerson Consultants Navigating the DSMT Reimbursement Maze in Todays Changing Environment Patty Telgener, RN, MBA, CPC VP of Reimbursement Emerson Consultants
More informationFrom Channeling to GRACE: Approaching Reduction in Readmissions and Adverse Drug Events
From Channeling to GRACE: Approaching Reduction in Readmissions and Adverse Drug Events Michael Wasserman, MD, CMD Executive Director, Care Continuum Health Services Advisory Group September 15, 2016 Quality
More informationHow Many Times? Result: an Unsatisfactory Outcome That Can Be Avoided
Removing Obstacles to a Peaceful Death by Revising Health Professional Training and Payment Systems Professor Kathy L. Cerminara Nova Southeastern University Shepard Broad College of Law October 24, 2018
More informationHospice: Life s Final Journey Are You Ready?
Hospice: Life s Final Journey Are You Ready? Anthony D Antonio Senior Director, Business Development Sodexo Senior Living Agenda I. Government Scrutiny and Hospice II. III. IV. What is Hospice? NHPCO Facts
More informationFinancial implications of promoting excellence in end-of-life and palliative care J. Brian Cassel, PhD
Financial implications of promoting excellence in end-of-life and palliative care J. Brian Cassel, PhD Senior Analyst, Oncology Business Unit, VCU Health System & Analytic Services Unit, VCU Massey Cancer
More informationA Decade of Data: Findings and Insights from the National Palliative Care Registry
A Decade of Data: Findings and Insights from the National Palliative Care Registry Maggie Rogers, MPH Senior Research Manager, CAPC Rachael Heitner, MA, CHPCA Research Associate, CAPC July 19, 2018 at
More informationFINANCES OF PALLIATIVE CARE
FINANCES OF PALLIATIVE CARE Andrew Molosky, MBA Vice President of Operations Seasons Hospice & Palliative Care Learning Objectives: Distinguish and identify the unique needs of one's organization as it
More informationPalliative Care and Hospice. University of Illinois at Chicago College of Nursing
Palliative Care and Hospice University of Illinois at Chicago College of Nursing 1 Learning Objectives Upon completion of this module, participants will be better able to: 1. Describe Palliative Care 2.
More informationTitle & Subtitle can knockout of image
Title & Subtitle can knockout of image LARGE OPENING IMAGE HERE 50 accc-cancer.org July August 2016 OI BY PATRICIA INAMA RODA, MSN, BS, RN, AND JAIME FRITCHMAN, BS A Community Comes Together to Help Patients
More informationPalliative Care and IPOST Hospital Engagement Network June 5, Palliative Care
Palliative Care and IPOST Hospital Engagement Network June 5, 2012 Jim Bell, MD Medical Director St. Luke s Palliative Care and Hospice Palliative Care The interdisciplinary specialty that focuses on improving
More informationThe Palliative Home Care Program: Our Agency s Experience
The Palliative Home Care Program: Our Agency s Experience NAHC Annual Meeting November 3, 2013 Washington, D.C. NAHC Annual Meeting November 3, 2013 Washington, D.C. Presented by: Karen Marshall Thompson,
More informationResearch Brief. Early Insights on Dental Care Services in Accountable Care Organizations. Key Messages. Introduction
Early Insights on Dental Care Services in Accountable Care Organizations Authors: Taressa Fraze, Ph.D.; Carrie Colla, Ph.D.; Benjamin Harris, B.A.; Marko Vujicic, Ph.D. The Health Policy Institute (HPI)
More informationPalliative Care in the Community
Palliative Care in the Community Carol Babcock, MFT Director Palliative Care, Navicent Health American College of Surgeons Commission on Cancer (CoC) Standard 2.4 Palliative care services are available
More informationMODULE 1 PALLIATIVE NURSING CARE
Curriculum MODULE 1 PALLIATIVE NURSING CARE Objectives Describe the role of the nurse in providing quality palliative care for patients across the lifespan. Identify the need for collaborating with interdisciplinary
More informationNational Stroke Association s Guide to Choosing Stroke. Rehabilitation Services
National Stroke Association s Guide to Choosing Stroke Rehabilitation Services Rehabilitation, often referred to as rehab, is an important part of stroke recovery. Through rehab, you: Re-learn basic skills
More informationEnsuring Access to Mental Health Services For All Chicagoans
Ensuring Access to Mental Health Services For All Chicagoans August 19, 2014 Bechara Choucair, MD Commissioner City of Chicago Mayor Rahm Emanuel Chicago Department of Public Health Commissioner Bechara
More informationNational Landscape of Hospital-Based Palliative Care: Findings from the National Palliative Care Registry
National Landscape of Hospital-Based Palliative Care: Findings from the National Palliative Care Registry Maggie Rogers, MPH Senior Research Associate, CAPC Tamara Dumanovsky, PhD VP Research & Analytics,
More informationPriority Area: 1 Access to Oral Health Care
If you are unable to attend one of the CHARTING THE COURSE: Developing the Roadmap to Advance Oral Health in New Hampshire meetings but would like to inform the Coalition of activities and services provided
More informationSamantha A. Carlson, LMSW OSW-C Director of Social Services Kalamazoo, MI
Samantha A. Carlson, LMSW OSW-C Director of Social Services Kalamazoo, MI Value of Survivorship Clinics: What they are, why the are being created, and supporting data and research Comprehensive Survivor
More informationThe Challenge. Bill Frist, M.D.!
The Challenge 5% of U.S. Population Spend 50% of Healthcare Dollars % of Healthcare Spending % of U.S. Population 5% of Medicare beneficiaries die each year accounting for 27.4% of Medicare expenditures
More informationPatient-Centered Oncology Payment: Payment Reform to Support Higher Quality, More Affordable Cancer Care (PCOP)
Patient-Centered Oncology Payment: Payment Reform to Support Higher Quality, More Affordable Cancer Care (PCOP) May 2015 Summary Overview The American Society of Clinical Oncology (ASCO) has devoted considerable
More informationMinistry of Health and Long-Term Care. Palliative Care. Follow-Up on VFM Section 3.08, 2014 Annual Report RECOMMENDATION STATUS OVERVIEW
Chapter 1 Section 1.08 Ministry of Health and Long-Term Care Palliative Care Follow-Up on VFM Section 3.08, 2014 Annual Report RECOMMENDATION STATUS OVERVIEW # of Status of Actions Recommended Actions
More informationIntegration How Can Behavioral Health And Health Care Be Better Coordinated?
Integration How Can Behavioral Health And Health Care Be Better Coordinated? Mental Health America Annual Conference June 8, 2013 Harvey Rosenthal, NYAPRS New York Association of Psychiatric Rehabilitation
More informationThank you for joining today, please wait while others sign in.
Webinar Instructions Thank you for joining today, please wait while others sign in. The audio portion of this call will be heard through your computer speakers. Please make sure your speakers are on and
More information9/19/2017. Population-Based Palliative Care: The Next Phase of Clinical Care, Education, and Research. Population-Based Palliative Care JR:
Population-Based Palliative Care: The Next Phase of Clinical Care, Education, and Research David Casarett, MD, MA Chief of Palliative Care Professor of Medicine Duke University/Duke Health Population-Based
More informationWIN-WIN-WIN APPROACHES TO ACCOUNTABLE CARE How Better Payment for Hospice and Palliative Care Can Benefit Providers, Patients, and Payers
WIN-WIN-WIN APPROACHES TO ACCOUNTABLE CARE How Better Payment for Hospice and Palliative Care Can Benefit Providers, Patients, and Payers Harold D. Miller President and CEO Center for Healthcare Quality
More informationMapping Palliative Care Need and Supply in California: Methodology
Mapping Palliative Care Need and Supply in California: Methodology February 2015 Kathleen Kerr, Kerr Healthcare Analytics Mike Rabow, MD, University of California San Francisco J. Brian Cassel, PhD, Virginia
More informationEvidence as a Tactic to Advance Pediatric Palliative Care
Evidence as a Tactic to Advance Pediatric Palliative Care Richard Goldstein, MD, Boston Children s Hospital-Harvard Medical School Maggie Rogers, MPH, Senior Research Associate, CAPC August 28, 2017 2017
More informationQuality of Life (F309 End of Life) Surveyor Train the Trainer: Interpretive Guidance Investigative Protocol
483.25 Quality of Life (F309 End of Life) Surveyor Train the Trainer: Interpretive Guidance Investigative Protocol 2 483.25 End of Life Each resident must receive and the facility must provide the necessary
More informationQuality and Fiscal Metrics: What Proves Success?
Quality and Fiscal Metrics: What Proves Success? 1 Quality and Fiscal Metrics: What Proves Success? Kathleen Kerr Kerr Healthcare Analytics Creating the Future of Palliative Care NHPCO Virtual Event February
More informationPreparing for New Hampshire Behavioral Health Summit December 3, 2015
Preparing for 2016 New Hampshire Behavioral Health Summit December 3, 2015 9.3 million more Americans have insurance Uninsured rate down to 11.9% Health spending historically low growth rate 3.7% 27
More informationThe National Palliative Care Registry and Impact on the Field of Palliative Care
The National Palliative Care Registry and Impact on the Field of Palliative Care Diane E. Meier Director, Center to Advance Palliative Care (CAPC) diane.meier@mssm.edu registry.capc.org April 25, 2018
More informationWhat You Need To Know About Palliative Care. Natalie Wu Moy, LCSW, MSPA RUHS Medical Center Hospital Social Services Director
What You Need To Know About Palliative Care Natalie Wu Moy, LCSW, MSPA RUHS Medical Center Hospital Social Services Director None of the faculty, planners, speakers, providers, nor CME committee members
More informationTHE GROWTH OF SPECIALTY PHARMACY
UnitedHealth Center for Health Reform & Modernization THE GROWTH OF SPECIALTY PHARMACY Current trends and future opportunities Issue Brief April 2014 Summary Innovative specialty drugs are providing important
More informationPalliative Care Series. Faculty School of Nursing
Palliative Care Series Faculty School of Nursing Palliative Care Series The purpose of this series of education module is to provide adequate preparation and educational support for LVNs in their practice.
More informationHow Can Palliative Care Help Your Patient Get Home Sooner?
How Can Palliative Care Help Your Patient Get Home Sooner? Annette T. Carron, D.O. Director Geriatrics and Palliative Care Botsford Hospital OMED 2014 Patient Care Issues That Can Delay Your Day/ Pain
More informationEnabling the Transition to Hospice through Effective Palliative Care
Enabling the Transition to Hospice through Effective Palliative Care Amber Jones, M.ED Center to Advance Palliative Care Objectives Identify continuity of care improvements to be realized by enhanced inpatient
More informationDesign, Results, and Implementation of a Whole Person Intervention for Late Life Care Steven Schroeder, MD
Design, Results, and Implementation of a Whole Person Intervention for Late Life Care Steven Schroeder, MD Creating a Whole Person Intervention for Patients with Serious Illness and their Caregivers Eric
More informationModule 1: Principles of Palliative Care. Part I: Dying Well. A Good Death Defined
E L N E C End-of-Life Nursing Education Consortium Geriatric Curriculum Module 1: Principles of Palliative Care Part I: Dying Well A natural part of life Opportunity for growth Profoundly personal experience
More informationObjectives. End-of-Life Exercise. Palliative Care Can Help Patients and Decrease 30-Day Hospital Readmissions.
Palliative Care Can Help Patients and Decrease 30-Day Hospital Readmissions. Objectives Describe how palliative care meets the needs of the patient and family. Discuss how out-patient palliative care can
More informationCoalition for Compassionate Care of California (CCCC)
PALLIATIVE CARE FOR HEALTH HOME PROGRAM PATIENTS IN CALIFORNIA Leah Morris, RN, MPH, NP Director of Policy and Payer Relations Coalition for Compassionate Care of California. Lael Duncan, MD Medical Director
More informationSAN FRANCISCO PALLIATIVE CARE TASK FORCE ISSUE BRIEF #2
SAN FRANCISCO PALLIATIVE CARE TASK FORCE ISSUE BRIEF #2 SURVEY FINDINGS NCISCO PALLIATIVE CARE TASK FORCE At the first San Francisco Palliative Care Task Force meeting held May 29, 2014, members were asked
More informationACO Congress Conference Pre Session Clinical Performance Measurement
ACO Congress Conference Pre Session Clinical Performance Measurement Lynne Rothney-Kozlak, MPH Interim VP, ACO Collaborative (Independent Consultant) October 25, 2010 Agenda for Presentation 1. The Framework
More informationPalliative Care at ARMC
Palliative Care at ARMC Jean Andrews, RN, BSN, CHPN November 27, 2012 What is Palliative Care? A service that provides education, comfort, and support for people with serious illnesses. A means of matching
More informationOral Health Provisions in Recent Health Reform: Opportunities for Public-Private Partnerships
Oral Health Provisions in Recent Health Reform: Opportunities for Public-Private Partnerships 2010 National Primary Oral Health Conference Tuesday, October 26, 2010 Catherine M. Dunham, Executive Director
More informationBring Palliative Care Into Your Office. Renee Baird, MSN, FNP-C, CHPN
Bring Palliative Care Into Your Office Renee Baird, MSN, FNP-C, CHPN Pal-ee-uh-tiv Kair Palliative care is both a philosophy of care and an organized, highly structured system for delivering care. The
More informationKeys to Sustaining SBIRT
Keys to Sustaining SBIRT. Reducing Adolescent Substance Abuse Initiative March 29 th, 2016, 1:00 2:30pm ET Dane Libart, OK Dept. of Mental Health & Substance Abuse Services Stephen Betts, Bill Wilson Center
More informationTrends in Hospice Utilization
Proposed FY 2017 Hospice Wage Index and Rate Update and Hospice Quality Reporting Requirements To: NHPCO Provider Members From: Health Policy Team Date: April 25, 2016 On April 21, 2016, the Centers for
More informationFocused on the Big picture
Focused on the Big picture Tamara M. Shearrow, MSN, NP-C, ACHPN Palliative Care Services Winchester Medical Center The presenter has no conflicts of interest to disclose. Objectives Understand how palliative
More informationPALLIATIVE CARE The Relief You Need When You Have a Serious Illness
PALLIATIVE CARE The Relief You Need When You Have a Serious Illness PALLIATIVE CARE: Improving quality of life when you re seriously ill. Dealing with any serious illness can be difficult. However, care
More information