NAHC Releases Palliative Care White Paper
July 6, 2015 09:33 AM
The National Association for Home Care & Hospice(NAHC) and its affiliates, the Home Care & Hospice Financial Managers Association (HHFMA) and the Hospice Association of America, unveiled a palliative care white paper.The white paper was formally presented at the HHFMA Financial ManagementConference this week in Nashville, TN.
Palliative care is not well-defined and state regulations and payer requirements for it vary.Palliative Care (PC) andits “cousin,”Advanced Illness Management, answer a significant need of today’s health care system; however, the absence of a regulated model of care and reimbursement create both opportunities and challenges for home health and hospice organizations that provide this service. This white paper is intended to share concepts and experience for providers who desire to explore and develop their own PC program.
The white paper is a comprehensive resource that addresses everything an organization needs to consider related to palliative care – the context of palliative care currently and in the future, what to consider in developing a palliative care service and how to structure it, to paymentand outcomes. There are a wide variety of palliative care services that are explored through the examination of four different existing models. Contributors to the white paper are:
Walter Borginis, Carla Braveman, Sharyl Kooyer, Cheryl Leslie, Pam Meliso, Bill Musick (Editor in Chief), Shawn Ricketts, Lynn Roberts, and Joshua Sullivan with review by NAHC staff and members of the Hospice Association of America’s (HAA) Advisory Board, a NAHC affiliate.
A panel led by Bill Musick presented the white paper at the Financial Manager's Conference. Each of the programs administered by the panelists was explained and similarities and differences highlighted. Each panelist shared why their program structure is best for his or her community, why it was started and some of the lessons learned.
As PC evolves, it will be increasing valuable for providers to share data related to best practices, predictive instruments/analytics, overcoming barriers and justification of PC in terms of Triple Aim goals (lower cost, higher quality/satisfaction and access). NAHC is committed to support this process through papers such as this one, topics for its conferences and webinars, and encouraging the sharing of best practices in general.
As best practices become clearer, public policy efforts by NAHC and its members to establish standardized approaches to delivery and reimbursement of PC are envisioned. NAHC will be monitoring the development of PC programswith the intent to recommendpolicy changes on a timeline and in a manner that supports the development of PC while not squelching innovation and creativity in the evolution of PC services. In alignment with the white paper, the immediate focus will be on support for the development of metrics for providers and insurance plans related to care at the end of life. Policy options for NAHC to consider include:
Establishment of a stand-alone Medicare Palliative Care benefit;
Testing of palliative care programs in the Centers for Medicare and Medicaid Innovations;
Permitting categorical waivers within Medicare shared savings initiatives, such as ACOs, that allow at risk entities to utilize Palliative Care services;
Authorizing MA Plans to provide Palliative Care services as part of a benefit extension;
Expanded and/or clarified standards for coverage of Palliative Care as part of the Medicare home health benefit through application of the Skilled Management and Evaluation of a care Plan service under 42 CFR 409.43 and 409.33 along with use of specific physician CPT codes on PC with adequate reimbursement to match.