• 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

• 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

• 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

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.

Value of a specialized solution

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