Community-based palliative care programs are growing to better meet the needs of chronically ill patients who may or may not qualify for home health services, but who need the physical and psychosocial support that palliative care services can provide.
The Role and Benefits of Palliative Care
A primary role of palliative care is the relief of pain and other emotional and physical symptoms, support for family caregivers, and attention to the social determinants of health and disease. Other key services are establishing goals of care, matching care plans to those goals, psychosocial, spiritual, and bereavement support, and coordination of care over time and across settings.
Community-based (home-based) palliative care programs can provide services to patients when symptom burden and mobility challenges make transport to other settings challenging. Home visits provide unique insight into a patient’s functional status, support system, medication adherence, and family caregivers.
Numerous studies have reported that community-based (home-based) palliative care for people with life-limiting conditions is associated with reduced use of acute care health services.
Community-Based Palliative Care in Value-Based Care Models
Home-based palliative care programs have been shown to decrease hospital utilization, lower costs, and increase hospice utilization.
A study, The Impact of a Home-Based Palliative Care Program in an Accountable Care Organization published in the Journal for Palliative Medicine, evaluated the impact of a home-based palliative care program in a Medicare Shared Savings Accountable Care Organization. The results of the study found that home-based palliative care delivered by a team of nurses, social workers, volunteers, and palliative care physicians led to a significant decrease in costs:
* 35 percent reduction in Medicare A costs,
* 37 percent reduction in Medicare B costs) and hospitalizations
* 34 percent reduction in hospital admission, and an increase in hospice utilization and length of stay
* 35 percent increase in hospice enrollment, 240 percent increase in hospice length of stay) during the last months of life