Archive for the ‘Palliative Care’ Category

9 Things to Know About Palliative Care

June 12th, 2014 by Cheryl Miller

With an aging population that is living longer—an estimated 10,000 baby boomers become eligible for Medicare each day — and a shortage of specialists trained for the field, palliative care is no longer taking a back seat to more traditional healthcare. The majority of respondents to the Healthcare Intelligence Network’s first annual Palliative Care survey in February 2014 said they have a palliative care program in place, and of those that don’t, more than half said they planned to launch a program within 12 months.

Here are nine benchmarks gleaned from the 2014 Palliative Care survey:

  • Timely referrals of patients to palliative care are one of the biggest challenges to implementing a program, according to 89 percent of respondents.
  • Frailty is a key characteristic of their palliative patient/member population, say 48 percent of respondents; other traits include impaired cognitive capacity (34 percent) and disabilities (15 percent).
  • „„Candidates for palliative care are primarily identified by physician referrals (78 percent).
  • More than half (60 percent) of respondents said that case management assessments were important tools for identifying palliative care candidates.
  • While the majority of respondents (68 percent) administer palliative care on an inpatient basis, more than half (54 percent) say care is conducted on home visits and just under a third offer palliative care at extended care facilities.
  • About 88 percent of respondents with palliative care programs reported an increase in patient satisfaction levels among Medicare participants, while 89 percent saw more satisfaction among caregivers.
  • Overall, the presence of palliative care helped to curb healthcare utilization costs for 70 percent of respondents.
  • Seventy-one percent of respondents with palliative care programs in place reported an uptick in hospice election by Medicare patients.
  • Nearly 20 percent of respondents said it was too early to tell what ROI their palliative care program generated.

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Excerpted from 2014 Healthcare Benchmarks: Palliative Care

2014 Market Data: The Hospital Perspective on Palliative Care

March 11th, 2014 by Patricia Donovan


The majority of palliative care consults take place in hospitals, according to 62 percent of respondents to HIN’s 2014 survey on Palliative Care, although many responding healthcare organizations are working to separate these consults from the hospital bedside. In the meantime, there were several key areas where hospitals and health systems, which comprised almost half of survey respondents, stood out in terms of how they conducted palliative care programs.

For example, when asked to identify candidates for palliative care, this sector was least likely to rely on a diagnosis set (27 percent within this sector, versus a high of 78 percent and a mean of 45 percent) and direct member/patient referrals (33 percent for this sector, versus a high of 78 percent within the health plan and an overall mean of 55 percent). When listing components of their palliative care programs, this sector was also least likely to include a patient/provider liaison (44 percent versus a high of 78 percent and a mean of 68 percent) and clinical assessment (71 percent versus a high of 89 percent and a mean of 82 percent).

The composition of this sector’s palliative care team also varied, starting with the presence of primary care physicians, or PCPs: (52 percent of hospital palliative care teams versus a high of 77 percent and a mean of 63 percent); oncologists (19 percent versus a high of 67 percent and mean of 31 percent); geriatricians (19 percent versus a high of 56 percent for case managers and a mean of 33 percent); and physical therapists (13 percent of hospitals versus a high of 67 percent and mean of 34 percent). However, this sector was most likely to have a nurse practitioner on board (62 percent versus a low of 11 percent for health plans and an overall mean of 43 percent).

The timing of palliative care consults has shifted over the years. This sector is most likely to conduct them during a hospital stay (85 percent, versus a low of 44 percent and mean of 60 percent) and the least likely to conduct them during a home visit (21 percent versus a high of 79 percent for home health agencies, not surprisingly, and a mean of 47 percent).

Where to administer palliative care has also shifted, and this sector was twice as likely to conduct it on an inpatient basis (94 percent) as home health agencies, at a low of 50 percent, and typically least likely to conduct it via telephonic visits (10 percent), one fourth as likely as health plans, at 44 percent.

Excerpted from: 2014 Healthcare Benchmarks: Palliative Care

Infographic: Few States Meet Palliative Care Benchmark

March 3rd, 2014 by Jackie Lyons

Only four states have effective strategies in place to improve access to and knowledge of palliative care services, according to the American Cancer Society Cancer Action Network.

State palliative care services are scored on a 0-6 scale, according to a new infographic from IMNG Medical Media. This infographic shows how each state scores on the scale, which combines grades from the Center to Advance Palliative Care’s national palliative care report card with actions on model legislation.

You may also be interested in this related resource: 2014 Healthcare Benchmarks: Palliative Care. Healthcare organizations need to be informed of new technologies and information sources. This 40-page report documents emerging trends in palliative care at more than 200 healthcare organizations, from the timing for initial palliative care consults to individuals on the palliative care team to the impact this specialized care is having on healthcare utilization and the patient experience.


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HINfographic: Parsing Palliative Care and the Patient Experience

February 19th, 2014 by Jackie Lyons

While ‘palliative’ literally means to cloak or conceal, healthcare is taking the wraps off this critical service — in spite of provider resistance. A well-timed palliative care consult can enhance the patient experience and foster appropriate use of healthcare resources.

Seventy percent of healthcare organizations have a palliative care program, according to a new infographic from the Healthcare Intelligence Network. This HINfographic provides information on initial care consultations, Medicare metrics impacted by palliative care, palliative care teams, challenges of palliative care and more.

Parsing Palliative Care and the Patient Experience

 title= You may also be interested in this related resource: 2014 Healthcare Benchmarks: Palliative Care. This 40-page report documents emerging trends in palliative care at more than 200 healthcare organizations, from the timing for initial palliative care consults to individuals on the palliative care team to the impact this specialized care is having on healthcare utilization and the patient experience — two critical markers of healthcare performance.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

Have an infographic you’d like featured on our site? Click here for submission guidelines.

Healthcare Business Week in Review: Home Visits; Patient Portals; Health Insurance Marketplaces; Hospital Pricing

January 17th, 2014 by Cheryl Miller

There is no place like home visits to address safety issues, and patient care concerns. Despite the explosion of mobile and telehealth technologies, there is no substitute for person-to-person contact — at least when it comes to populations at high risk of hospital admission or readmission, the results of the Healthcare Intelligence Network’s inaugural Home Visits study indicate. Three-fourths of healthcare organizations visit some percentage of their patients or health plan members in their homes in order to keep patients safer and healthier and to keep readmissions and costly utilizers at bay.

But there is a time and place for telehealth technology, and new research in the journal Medical Care shows that diabetics who used an online patient portal to refill medications and schedule their appointments, among other tasks, increased their medication adherence and improved their cholesterol levels by 6 percent, compared to occasional users or non-users. Researchers say the current study provides new evidence that patient portals may help patients adhere to their medications and achieve improved health outcomes.

About one-quarter of Americans potentially eligible for health coverage visited insurance marketplaces by December, up from 17 percent in October, according to a new Commonwealth Fund survey. Forty percent of these visitors were young adults; three-quarters said they were in good health; and more than half said they are likely to try to enroll by the March 2014 deadline. The survey, conducted between December 11 and 29, 2013, is the second in a series aimed at tracking Americans’ experiences with the marketplaces in the ACA’s first open enrollment period. The first Commonwealth Fund survey, conducted in October, found that 17 percent of people potentially eligible for coverage had visited the marketplaces during the first month.

Despite increasing scrutiny on hospital pricing practices, some U.S. hospitals are charging more than 10 times their cost, or nearly $1200 for every $100 of their total costs, according to new data released by National Nurses United (NNU) and the Institute for Health and Socio-Economic Policy (IHSP).

The 100 most expensive hospitals listed charge 765 percent and higher, more than double the national average of 331 percent, the report says. Fourteen U.S. hospitals charge more than $1,000 for every $100 of their total costs (a charge to cost ratio of 1,000 percent) topped by Meadowlands Hospital Medical Center in Secaucus, NJ, which has a charge-to-cost ratio of 1,192 percent. California, with a statewide average of 451 percent charge to cost ratio, ranks third overall in the United States. The detailed report includes the most expensive hospitals, the top 10 for each state, and the 50 most expensive hospital systems.

Discussions about end-of-life care for adults are never easy; they are even more difficult when they concern children. The National Institute of Nursing Research (NINR) has launched a new campaign, Palliative Care: Conversations Matter, that is designed to help children and families navigate a serious illness, and better inform them of supportive resources. A component of the National Institutes of Health (NIH), it brings together parents and palliative care clinicians, scientists, and professionals, who give their input and expertise on what they feel is needed in the field. Don’t miss the video which tells one mother’s story about her daughter’s bout with neuroblastoma and how palliative care helped them through it.

You can share your organization’s work in palliative care in our current e-survey: 10 Questions on Palliative Care. With more organizations focusing on palliative care as a means to enhance the patient experience during advanced or terminal illness, many are strategizing new ways to assess and address patients’ needs at this time, from consultations in the ED to face-to-face evaluations in outpatient clinics. Describe your organization’s efforts in palliative care by February 7, 2014 and you will receive a free summary of survey results once it is compiled.

Our congratulations to one of our survey participants, Timothy Price, a market research analyst with Caresource, who was randomly selected as the winner of our training DVD from our 10th annual Healthcare Trends & Forecasts webinar.

Early Palliative Care Improves Patient Care, Reduces Hospitalizations

January 15th, 2014 by Cheryl Miller

The word palliative literally means to cloak or conceal, and is used to describe care designed to alleviate the extreme pain and suffering of those with chronic or terminal illnesses.

It’s an ironic name for a subject many medical professionals would prefer be concealed. There’s a shortfall of as many as 18,000 board certified physicians focused on palliative care and hospice care in the United States. There are 5,150 hospice programs and 1,635 hospital palliative care teams in the United States, which means there’s only one specialist for every 20,000 older adults living with a severe chronic illness, according to the American Academy of Hospice and Palliative Medicine.

Certification roadblocks and lower salaries account for part of this shortage; but, it could also be chalked up to discomfort with the subject. According to a study from Massachusetts General Hospital, which surveyed over 4,000 physicians caring for cancer patients, researchers found that while the vast majority of them said they would personally enroll in a hospice program if they received a terminal cancer diagnosis, less than one-third said they would discuss hospice options with their cancer patients early in their diagnosis.

But new research, including the results to our current 10 question survey on palliative care, is showing that palliative care programs are increasing, and can improve the patient experience and help avoid costly hospitalizations. New York University College of Nursing researchers and colleagues reporting in the Journal of Palliative Medicine found that initiating a palliative care consult in the emergency department (ED) reduced hospital length-of-stay (LOS) by 3.6 days when compared to patients who received the palliative care consult after admission. The ED is a setting for triage, treatment, and determining the sick patient’s subsequent course of care, which in this case includes a dedicated palliative care unit.

“By providing early palliative care, patient needs are met earlier on, either preventing admission or reducing length of stay and treatment intensity for patients, which reduces costs to Medicare and the government,” says New York University College of Nursing researcher and Assistant Professor Abraham A. Brody, RN, PhD, GNP-BC. “Patients receiving palliative care are less likely to be readmitted as well. Early palliative care can better help patients to have their wishes met, and allow them to return to and stay at home.”

Helping people decide how they want to spend the rest of their lives, and granting their wishes might be the most important palliative care treatment of all. NPR reports on Dr. Tim Ihrig of Trinity Regional Medical Center in Fort Dodge, Iowa, who makes house calls to his patients nearing their end of life. “What are the three most important things to you,” he asks his patient, an 86 year-old wife, mother, grandmother, and great grandmother with congestive heart failure. She answers: “My girls, playing cards once a week, and counting money for the church once a month,” and he helps her to achieve that. Patients in palliative care at Trinity Regional Medical Center cost the healthcare system 70 percent less than other patients with similar diagnoses, hospital officials say.

And palliative care isn’t going away, in fact, it’s spurred a new HBO comedy series, Getting On. Taking place in an extended care facility, the short-staffed ward tries their best to tend to their patients — some of whom have Alzheimer’s disease, but most of whom are simply old &#151 while hoping they don’t lose their Medicare reimbursement. The series makes jokes about everything from displaced fecal matter to sex, attempting to make fun out of a subject that’s been cloaked, or concealed, for a long time. Whether the series is renewed remains to be seen, but at the very least it’s provided a look at the kindness a group of workers can give their patients nearing the end of their life.

Healthcare Business Week in Review: Yoga for Caregivers, Diabetes Management, Healthcare Coverage

August 2nd, 2013 by Cheryl Miller

Offering yoga and meditation classes to caregivers of seriously ill patients just prior to starting clinical meetings on palliative care issues is one detail that sets Mount Sinai Hospital’s palliative care program apart from others. Together with Denver Hospice and Optio Health Services in Colorado, and UnityPoint Health Palliative Care Program in Iowa and Illinois, these three palliative care programs received the 2013 Circle of Life Award®, along with five others that were awarded Citations of Honor from the American Hospital Association (AHA).

Other programs involve a community-wide program to embrace the growing Hispanic community, and regular outpatient and home visits to ensure proper care transitions, and help avoid unnecessary emergency room visits and readmission to the hospital. All of the programs set out to reexamine the roles palliative care plays in healthcare by creating and championing end-of-life care for patients and caregivers throughout the healthcare system.

Providers need to reexamine certain diabetes monitoring practices that solely target acute individuals, and instead take a population health management approach to improving diabetes care, according to a Phytel study published in the American Journal of Managed Care.

Researchers found that despite national attention, uncontrolled diabetes was growing, and those patients at real risk were those that waited to seek care until their condition was exacerbated to an acute phase. A broader population-based approach was required to catch at-risk patients. Researchers recommend that provider organizations take two important steps to improve their ability to help their patients better manage their diabetes, including reaching out to their entire population between office visits so patients waiting too long to get retested are motivated to have the testing done earlier.

Economists need to reexamine their data linking the employment rate with healthcare coverage. Despite economic reports showing that the recession is over, the percentage of workers with health benefits still remains low, according to a new report by the nonpartisan Employee Benefit Research Institute (EBRI).

Links between the employment rate and health insurance coverage have been documented over the years. Since most workers in the United States get their health coverage through their jobs, a rise or drop in the unemployment rate usually means a corresponding rise or drop in the uninsured rate as well, the report states.

But these facts aren’t holding up against trends that show that nearly half of the population does not have coverage.

We’d like you to examine and respond to our current e-survey on the population health management of dual eligibles. These nine million Americans eligible for both Medicare and Medicaid present unique challenges. Public and private payors are now tailoring care coordination strategies for Medicare-Medicaid beneficiaries that are both geared to their medical, social and functional needs and cost-efficient. Describe your organization’s approach to care coordination of dual eligibles by August 6, 2013 and you will receive a free summary of survey results once it is compiled.