Despite evidence of the benefits of community-based palliative care (CBPC) and data indicating that our current capacity is insufficient to meet the need, growth of these services has likely been slowed by the lack of adequate, defined funding streams. To address these challenges, from 2014 to 2017, CHCF supported a planning and implementation process for six teams of payer and provider organizations committed to strengthening and spreading CBPC services in California. Participating providers included large academic medical centers, hospices, and a specialty palliative care practice, while the payers included national insurers, regional insurers, and a Medicaid managed care plan.

Payer-provider teams participated in a six-month planning process during which they developed operational and financial plans for delivering palliative care services in community settings (clinics, patient homes, and tele-visits), followed by a 24-month implementation phase where contracts were executed and services were launched. This kind of collaboration between payers and providers is an emerging trend in CPBC, and our grantees were among the first to participate in such efforts.

Growth of community-based palliative care services has likely been slowed by the lack of adequate, defined funding streams.

This series, Lessons Learned from Payer-Provider Partnerships for Community-Based Palliative Care, explores lessons about the process of developing and enacting agreements to deliver CBPC, including:

  1. Initial Engagement
  2. Defining the Eligible Population
  3. Promoting Appropriate Referrals
  4. Service Design and Operational Issues
  5. Payment Issues
  6. Metrics and Assessing Impact
  7. Monitoring and Modifications
  8. Relationship Issues

Explore the lessons, and download PDF versions of each, below. Download the full report here, or read the Quick Tips sheet for a brief overview.