Value-Based Care and NHPCO feedback
The American healthcare industry is undergoing a significant transformation, shifting from the traditional fee-for-service model to value-based care (VBC). This transition aims to improve patient outcomes, enhance care quality, and reduce overall healthcare costs. As healthcare providers and payers increasingly adopt VBC models, they are incentivized to focus on preventive care, care coordination, and patient-centered approaches rather than the volume of services provided. This shift presents both challenges and opportunities for various healthcare sectors, including palliative and hospice care.
Palliative and hospice care providers are uniquely positioned to play crucial roles in managing the upside and downside risks associated with value-based contracts. These specialized care providers can contribute significantly to achieving VBC goals by focusing on improving quality of life, managing symptoms, and providing emotional support for patients with serious illnesses. By emphasizing care coordination and patient-centered approaches, palliative and hospice care can help reduce unnecessary hospitalizations, emergency room visits, and costly interventions, thereby lowering overall healthcare costs. Additionally, these providers can enhance patient and family satisfaction by aligning care with patients' preferences and goals, which is a key component of VBC models.
Advance care planning (ACP) is a critical element in achieving value-based goals, particularly in end-of-life care. ACP involves discussions between patients, their families, and healthcare providers about future care preferences and treatment options. By facilitating these conversations, healthcare providers can ensure that care aligns with patients' wishes, leading to improved patient and family experiences. Moreover, ACP has been shown to reduce healthcare costs by avoiding unwanted or unnecessary treatments and hospitalizations. Studies have demonstrated that ACP can lead to lower end-of-life costs while improving the quality of care and patient outcomes. As the healthcare industry continues to evolve towards VBC, integrating ACP into standard practice will be crucial for delivering high-quality, cost-effective care that respects patients' values and preferences at the end of life.
Last winter, I spoke at the National Hospice and Palliative Care Organization's (NHPCO) Annual Leadership Conference about these very topics. After the talk, I met with various clinicians and administrators hearing where they were at in their journey from FFS to VBC. Some of that dialogue is below:
"I will encourage our directors to work with local hospital to get hospice involved earlier. Unfortunately, we do not have PC yet. Working on it."
"Time to reevaluate our community ACP approach, really start exploring transition from FFS to VBC across our service line"
"Will be reaching out to my leadership and getting more involved in VBC implementation"
"This was the first time I heard anything positive about Managed Medicare!"
"We don't talk to people enough about medically unnecessary care."
I will be speaking more on this topic at Minnesota Network of Hospice and Palliative Care's (MNHPC) Annual Conference on April 8th.