State Medicaid Palliative Care Efforts

October 31, 2023
Care Models
2 min
Justin Hallen, VP Partnerships

While other states have made significant strides toward improving palliative care benefits, Hawaii's the first state to implement a palliative care benefit through a State Plan Amendment, making it a permanent part of the state's Medicaid program. This sets a precedent for other states to follow and could help make palliative care more accessible to people across the country. Hawaii is seeking to cover palliative care services as preventive, as services alleviating undue pain and symptoms, burden on the family caregiver, and avoidable emergency room visits, and hospital stays. This can also mean that some financial barriers to care, such as a copayment, for palliative care services would not be required should payors apply this definition.

One such initiative relates to community-based palliative care services, delivered by an interdisciplinary team of specialists, supporting a person with a serious illness and their caregiver through advance care planning, care coordination, and pain and symptom management. Hawaii's new palliative care benefit will provide coverage for a variety of services, including pain management, symptom control, emotional support, spiritual support, and practical support such as help with transportation and childcare. The benefit will be available to all Medicaid beneficiaries in Hawaii, regardless of their age or income.

Palliative care is a type of care that focuses on providing relief from the symptoms and stress of a serious illness. It can be provided at any stage of an illness and can be used in conjunction with curative treatments. Palliative care is important because it can help people live more comfortably and with dignity, regardless of their prognosis.

The integration of palliative care into Medicaid programs is a positive development for both patients and providers. For patients, it means that they will have access to high-quality palliative care services, regardless of their income or insurance status. For providers, it means that they will be able to offer their patients a more comprehensive range of services.

We support any plan that moves advance care planning discussions and awareness of palliative care options, upstream. It’s important to ask what care options are available when discussing with your provider your end-of-lifecare plan.