There is growing recognition among health care providers and payers of the need to address the often overlooked non-clinical issues that can impact care quality. These issues are often associated with social determinants of health, such as food insecurity, low health literacy, or need for transportation to fill prescriptions or attend physician appointments. Left unaddressed, they represent serious gaps in care that frequently lead to unplanned care and poor health outcomes.
Given their emphasis on rehabilitation and recovery, skilled nursing facilities aren’t typically places where patients receive palliative care.
Medicare Advantage Expansion Foreshadows Growth of Home-Based Palliative Care Population Health Solutions
As the nation’s senior population booms, and more of them turn to Medicare Advantage (MA) plans for coverage, expect growing reliance on home-based population health palliative care solutions, especially now that CMS has approved coverage of supplemental benefits.
The traditional one-size-fits-all benefits strategy is facing a new era of complexity with 2018 finalized guidance and policies from the Centers for Medicare & Medicaid Services (CMS) enabling Medicare Advantage (MA) programs to expand the supplemental benefits1 afforded to beneficiaries.
Loneliness and social isolation, the complete or near-complete lack of contact between an individual and society, can be acutely troublesome for seniors. That is particularly true for those who are experiencing a serious or advanced illness, where symptoms and impaired mobility make the effort required to socialize with friends and family challenging.
The Centers for Medicare & Medicaid Services (CMS) loosened reimbursement limitations on home healthcare and home-based palliative care and it resulted in a range of issues that became high-profile areas for accelerated discussions and continued coverage.
Health disparities and complex social determinants of health (SDoH) have historically compromised patient access to quality care. But policy changes announced recently from the Centers for Medicare & Medicaid Services are expected to mitigate these challenges.
One of the most notable synergies in this current healthcare environment is the growing complement between two disciplines: population health, which focuses on improving the health of populations, with a special emphasis on reducing disparities in health outcomes and improving the value of health care, and palliative care, which focuses on improving the quality of life for patients and families facing the challenges of a serious or advanced illness.
Care coordination involves deliberately organizing patient care activities and sharing information among all of the participants concerned with a patient’s care to achieve safer and more effective care. This means that the individual’s needs and preferences are known ahead of time and communicated at the right time and to the right people.
Disproportionate spending on the care of individuals as they approach the end of life is an issue that is generating significant discussion among legislators, healthcare payers and the private sectors.