Fitting Palliative Care Into ACOs

Incorporating palliative care into the accountable care organization equation can deliver both care quality improvements and cost reductions, according to a Health Affairs blog post.

Palliative care is specialized medical care for patients with serious illnesses. It focuses on providing those patients with relief from symptoms, pain and stress of their illnesses.

The blog post, penned by Susan Block, MD, chair of the department of psychosocial oncology and palliative care at the Dana-Farber Cancer Institute and Brigham and Women's Hospital in Boston; Vicki Jackson, MD, MPH, division chief for palliative care at Massachusetts General Hospital in Boston; and Thomas Lee, MD, CMO at Press Ganey; says the focuses of palliative care can be especially valuable in the ACO space.

First, palliative care can improve quality and patient experience, two prongs of the triple aim. According to the blog post, palliative care can help achieve minimization of suffering and improve quality of life for patients with far-advanced diseases.

Additionally, palliative care can reduce costs through reduced length of stay, readmission rates and use of the emergency department while increasing hospice length of stay, the blog post states. "Hospice care is less costly than care in other settings for patients with advanced illness, primarily because it reduces hospitalizations," the authors wrote.

Partners Health System in Boston is one example of an ACO that successfully incorporated palliative care in its strategy. "Since PHS became an ACO, the focus on palliative care integration has increased, and been centered on improving quality by matching a patient's care to his or her individual goals and values," the authors wrote.

For instance, PHS has developed uniform standards for palliative care throughout its system and developed palliative care consultation "triggers" in the inpatient and outpatient settings, among many other initiatives detailed in the post.

While the focus on palliative care has helped PHS' ACO improve quality and reduce costs, the authors noted the shortage of palliative care providers has been a barrier to expanding its integration in the system.

More Articles on Palliative Care:
Earlier Palliative Care Improves Cancer Patient Satisfaction
Cambia Health Aims to Curb Severe Palliative Care Shortage
NIH Launches Pediatric Palliative Care Campaign

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