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When health plans and palliative care clinicians come together about contracting, progress can be slow before things even get started. It can take months of discussion just to come to an agreement on what home-based palliative care (HBPC) is — including basic things such as what services are included. And what worked for one plan/provider agreement may not work for the next one, which means starting the negotiation cycle from scratch each time.
Six years ago, some payers and providers in California realized there had to be a better way and asked one another, “Why don’t we just agree on what the basic, minimal standards for HBPC are, so we can move more quickly to actually meet the needs in our communities?” With leadership from the Coalition for Compassionate Care of California (CCCC), that is exactly what they did.
In partnership with Blue Shield of California, CCCC convened representatives from California health plans, palliative care providers, policy advocates, researchers, and other stakeholders in 2016. Their charge was to establish minimum standards to inform contracting for HBPC, no matter the payer. The goal was to clarify for everyone — including patients and families — what could be expected when we say, “Yes, we have a home-based palliative care team.”
Read the entire article at the Center to Advance Palliative Care website.
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.
Judy Thomas
Judy Thomas, JD, is CEO of the Coalition for Compassionate Care of California, which serves as the home of the palliative care and serious illness movement in California. She is an attorney with over 25 years of experience and a proven track record in changing health care standards of practice by combining public policy with practical implementation.
