Palliative Care Teams’ Cost-Saving Effect Is Larger For Cancer Patients With Higher Numbers Of Comorbidities

A new study published in Health Affairs found that palliative care reduces hospital costs for incurable cancer patients who have other serious health conditions. Targeting early specialist palliative care for these patents could improve care could cut costs.

Patients with multiple serious conditions account for a high proportion of health care spending, and the impact of palliative care consultation on hospital costs for adults with advanced cancer, excluding those with dementia, was evaluated. It was found that, compared to usual care, the receipt of a palliative care consultation within two days of admission was associated with 22 percent lower costs for patients with a comorbidity score of 2–3 and with 32 percent lower costs for those with a score of 4 or higher. Earlier consultation was also found to be systematically associated with a larger cost-saving effect for all subsamples defined by multimorbidity.

Read the full Health Affairs article.

Recommendations for Best Communication Practices to Facilitate Goal-concordant Care for Seriously Ill Older Patients With Emergency Surgical Conditions

On September 3, 2014, an advisory panel of leaders in surgery, palliative medicine, critical care, emergency medicine, geriatrics, anesthesiology, and health care innovation was convened and funded by Ariadne Labs, a joint center for health systems innovation of Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health. The panel addressed the need to improve communication practices to facilitate goal-concordant care for seriously ill, older patients with surgical emergencies. Participants were asked to translate their broad spectrum of experience and knowledge into best practices for communicating with these highrisk surgical patients. The objective of the 1-day meeting was to establish key elements of a communication framework to support surgeons, patients with serious illness, and their families in decisions about surgery in the acute setting.

Review the recommendations. Read the associated editorial “Best Practices: Targeting Surgeon Communication at the End of Life”.

Diane Meier, MD Quoted in National Journal on Changes to the Medicare Program

A recent article in National Journal discussed the January 1st change to the Medicare program that will reimburse physicians for having advance care planning conversations with patients.

“It’s a signal,” said Diane Meier, Director of the Center to Advance Palliative Care. “This decision by [the Centers for Medicare and Medicaid Services] to enable clinicians to be able to be paid for having these conversations is a kind of social signal that the government thinks that doctor-patient communication is important enough to pay for it.”

Read the rest of the article here.

First-ever CMS Innovation Center Pilot Project to Test Improving Patients’ Health by Addressing Their Social Needs

On January 5, 2016, The Department of Health and Human Services announced a new funding opportunity of up to $157 million to test whether screening beneficiaries for health-related social needs and associated referrals to and navigation of community-based services will improve quality and affordability in Medicare and Medicaid. Many of these social issues, such as housing instability, hunger, and interpersonal violence, affect individuals’ health, yet they may not be detected or addressed during typical health care-related visits. Over time, these unmet needs may increase the risk of developing chronic conditions and reduce an individual’s ability to manage these conditions, resulting in increased health care utilization and costs.

The five-year program, called the Accountable Health Communities Model, is the first Centers for Medicare & Medicaid Services (CMS) Innovation Center model to focus on the health-related social needs of Medicare and Medicaid beneficiaries, including building alignment between clinical and community-based services at the local level. The goal of this model is that beneficiaries struggling with unmet health-related social needs are aware of the community-based services available to them and receive assistance accessing those services.

Read the full press release.

Hospice Payment Reforms Are A Modest Step Forward, But More Changes Are Needed

A January 4, 2016 Health Affiars Blog article discussed the Centers for Medicare & Medicaid Services (CMS) final rule to update the Medicare hospice payment rates and wage index. The article addressed the exclusion of palliative care services, like hospice, from Medicare Advantage and other integrated payment models.

The authors argued for palliative care based on need, not prognosis, and called for more changes, saying, “we need to do more than tinker with the level of per-diem payments to ensure the program’s long-run effectiveness. In fact, policymakers should look beyond the benefit itself to consider its role in the broader health care system. With all the success of Medicare’s hospice benefit, the barriers to early and appropriate integration of hospice and palliative care services for beneficiaries with advanced illness are still substantial.”

Read the full article here.

Applications for 2016 Sojourns Scholar Leadership Program Has Launched 

The Sojourns Scholar Leadership Program is an initiative designed to identify, cultivate and advance the next generation of palliative care leaders. The program seeks to support outstanding nurse and physician emerging leaders in education and practice by investing in their professional development. Sojourns Scholars receive $180,000 in funding ($90,000/year over a two year grant) to conduct an innovative impactful clinical, research, education or policy project in the field of palliative care and implement a leadership career plan all designed to support their growth as leaders in the field.

The Cambia Health Foundation is now accepting applications for this program, which is designed to help cultivate the next generation of palliative care physician and nurse leaders. The deadline for applications is February 26, 2016.

For more information, or if you are interested in applying, visit Cambia Health Foundation.

The Dana-Farber Cancer Institute Research Fellowship in Psychosocial Oncology and Palliative Care

The Dana-Farber Cancer Institute Research Fellowship in Psychosocial Oncology and Palliative Care is directed toward physicians, psychologists, doctorally-prepared nurses, social workers, and other clinicians who wish to prepare themselves for an academic research career in palliative care or psychosocial oncology. The goal of this fellowship is to train early investigators prepared to move these fields forward through the conduct of highest quality research.

Learn more about the fellowship.

Comfort Care for Patients Dying in the Hospital

J. Andrew Billings, M.D., a leader in the palliative care field, outlined the need for basic palliative care training for all physicians in this review article in the New England Journal of Medicine.

“Nearly a half century after the founding in London of St. Christopher’s, the first modern hospice, in 1967, palliative care has been recognized throughout the world as an important medical specialty. Considerable advances have been made during that time in our knowledge of the management of symptoms in terminal illnesses — advances that deserve widespread incorporation into the clinical practice of both generalists and specialists. The information presented here should provide clinicians in fields other than palliative care with a framework for delivering basic comfort care to hospitalized patients who are near death.”

Read the full article here.

Palliative Care: A Key to Living With Dignity

AARP President Jeannine English wrote about palliative care for the December 2015 issue of AARP The Magazine . Her article argued for Medicare facilitating more appropriate use of palliative care outside of hospice and letting beneficiaries know about it as an option. The article also highlighted a video about hospitals adding palliative care clinics, which featured Dr. Diane E. Meier, Director of CAPC, and  Wall Street Journal’s Laura Landro.

Read the full article, and watch the video here.

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