Demonstrate their commitment to members with a serious or advanced illness
Assess their programs for palliative care
Evaluate the value that they bring to your customers
Determine the effectiveness of their focus on delivering quality care while balancing cost

Escalating costs for payers

will quadruple 5 percent of beneficiaries in their last year of life recent study

48.7 percent (nearly half) of older Medicare beneficiaries were classified as “high persistent,” maintaining high spending throughout the year;
10.2 percent showed a “progressive” pattern, starting low but increasing steeply;
29.0 percent of decedents were “moderate persistent,” mimicking the “high persistent” pattern except for a spending dip a few months prior to death;
12.1 percent of the sample exhibited a “late rise” in the final four months of life after very low spending in the earlier months of that final year.

Palliative care benefits payers and members

New England Journal of Medicine nearly three months longer National Center for Biotechnology Information

Focuses on care coordination across all settings
Emphasizes ongoing support at home
Ensures advance care planning
Engages physicians and other care providers
Provides integrated, dedicated, interdisciplinary, team-based care
Establishes goals of care
Addresses needs of those who are ineligible or those who refuse hospice
Identifies gaps in care
Provides pain and symptom relief
Facilitates disease understanding and self-management
Offers psycho-social support

Primary and secondary diagnoses
Medical and hospitalization/ED history
Functional status and activities of daily living
Symptom assessment
Medication review; adherence assessment
Adequacy of home, family, safety and financial supports
Patient's understanding of illness
Goals of care/Advance Care Planning
Services in place or needed
Patient risk evaluation
Palliative Plan of Care

Relief for working caregivers

to accommodate their caregiving duties to cope with the caregiving experience support caregivers

Advance care planning

Getting information on the types of life-sustaining treatments that are available.
Deciding what types of treatment one would or would not want if diagnosed with a life-limiting illness.
Sharing one's personal values with loved ones.
Completing advance directives to put into writing what types of treatment one would or would not want should one be unable to speak for oneself.

Source: https://www.nhpco.org/advance-care-planning

Value of a specialized solution

focus on comfort and quality of life

Innovate and differentiate services

Greer Myers is President, Turn-Key Health and EVP, Chief Development Officer, Enclara Pharmacia. With more than 20 years of health care experience, he joined Enclara Healthcare in 2014, and maintains dual roles as its President of Turn-Key Health and its Executive Vice President of Corporate Development of Enclara Pharmacia. Bringing strengths in post-acute operations, mergers and acquisitions, pharmacy benefits management, strategy and business development, he also has strong vertical experience in payer, provider and healthcare IT verticals.

Instant Insights /

Tough questions & palliative care

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