Evaluating Fiscal Outcomes for Outpatient Palliative Care

Leaders of public hospital outpatient palliative care (OPPC) services — specialty palliative care provided in clinics or physician offices — often need to quantify the economic impact of their programs when making the case to health system clinical and administrative leaders to secure resources needed to sustain, improve, or expand OPPC. Similarly, palliative care leaders planning a new OPPC program often need to provide estimates of how many patients might use the clinic and how the clinic will impact fiscal and utilization outcomes.

The materials provided here offer guidance on how to conduct analyses that quantify economic outcomes for established OPPC clinics and how to estimate the impact of proposed clinics.

• Evaluating Fiscal Outcomes of Palliative Care Clinics in Public Hospitals (PDF) describes options for analyzing fiscal outcomes for active palliative care clinics. Information is appropriate for palliative care clinical leaders and the health system analysts who will help select and conduct feasible analyses that generate the needed information.
• Palliative Care Clinics: Evaluating Opportunities and Projecting Possible Fiscal Impact (PDF) describes four approaches to quantifying the need for and the potential impact of a proposed palliative care clinic. Each approach uses different data sources to capture information on the number of potential patients, baseline use and costs of health services, and the potential reduction in health care use and costs that could be expected if a PC clinic is created.
• Technical Document: Detailed Instructions for Conducting the Opportunity Analysis and Using the Supportive Care Calculator (PDF) provides detailed, technical guidance on how to conduct the Opportunity Analysis for Outpatient Palliative Care, a comprehensive assessment of the need for and expected impact of OPPC. The document is intended for use by health system analysts with access to claims data. The analysis uses two spreadsheet tools (OA Table 1 [zip] and OA Table 2 [zip]) that generate data describing the number of potential patients and how they are currently using health care services, including inpatient palliative care and hospice. These data are then entered into the accompanying Supportive Care Calculator (zip), which generates estimates of possible patient volumes, visits, staffing costs, and potential impact on costs and patient use of health care services.
• References for Measuring Fiscal (and Other) Outcomes of Outpatient Palliative Care (PDF) is a list of selected peer-reviewed studies that describe economic outcomes for OPPC. Included are notes on the methods and setting for each study, as well as key findings.

Authors & Contributors

J. Brian Cassel

J. Brian Cassel, PhD, is a health services researcher at Virginia Commonwealth University School of Medicine who focuses on financial outcomes of palliative care. He also assists palliative care teams in program design, implementation, and evaluation.

Kathleen Kerr

Kathleen Kerr is a partner in the consulting firm Transforming Care Partners. Her work is focused on promoting the development of sustainable, high-quality palliative care programs, with particular emphasis on payer-provider partnerships and supporting programs that serve Medicaid enrollees.