As the hospice landscape shifts and hospice care is delivered more widely, another care type has made entry into the conversation: palliative care. However, unlike hospice services, which have a distinct payment model supported by the Centers for Medicare and Medicaid Services (CMS), palliative care has less established infrastructure for delivery.
It is no less important, however, and given some of the synergies across care types, many hospice providers report they are exploring entry into palliative care, if they haven’t already begun offering these services. In fact, 80% of respondents to a 2022 Hospice News industry survey sponsored by Axxess who reported their organizations do not yet offer palliative care said they were considering adding palliative care to the service lines. The shift does present challenges, however.
“There aren’t as many regulations around palliative care yet, which means that a lot of care organizations are piecemealing their teams together in ways that make sense,” says Amy Rose, palliative care product director for Dallas-based hospice and home health care software provider Axxess. “But it’s proving outcomes and it’s making waves.”
Creating a Solution for Palliative Care
Because palliative care does not currently have a single payer, many organizations that offer palliative care are responsible for tracking their own outcomes and service delivery so it can be billed and paid outside of the traditional hospice and home health billing processes. Every organization structures its care approach a little differently and delivers that care in a variety of care settings. The landscape shifts relative to these changing elements.
“Because it’s a shifting landscape, we know that what providers need today might not be the same thing that they need two years from now,” Rose says.
Based upon the request of a hospice customer, Axxess began to develop a palliative care-specific technology platform in 2021. This standalone care solution was created by palliative care professionals, meaning they were able to apply their experience toward the software development — with Rose, as a certified hospice and palliative care nurse — leading the charge.
“The story was about an organization that asked for it,” Rose says. “We believe in partnership, and this organization was a good partner and we wanted to be able to meet their enterprise needs. We knew that what they had at their disposal from a hospice perspective wasn’t enough for palliative care. There needed to be something special and differentiated.”
A year later, Axxess launched the product, leveraging its existing connection to Medicare billing and other payers to offer a solution that enables payment regardless of the care setting or palliative care arrangement.
“Palliative care looks different for everybody,” Rose says. “Sometimes it’s a risk-based arrangement, sometimes it’s more traditional Part B billing which is more the primary care type model…the really unique thing that we’ve created in this solution is the ability to do both.”
Palliative Care and the Continuum
With many providers already offering hospice care, having a palliative care-specific technology solution can make adding palliative care offerings more enticing. Whether an organization is providing palliative care as part of an interdisciplinary team, or if it includes nursing or social work documentation, a palliative platform builds in the flexibility for care providers to offer care and bill for their services in the current dynamic landscape. Further, it should integrate with hospice and home-based care offerings for providers that are already offering those care types.
The ability to capture data and outcomes is also working to make palliative care more readily available across the care continuum, Rose says.
“If you can’t prove your [palliative care] outcomes, you don’t have a program because there’s not a lot of funding for it,” she says. “[The technology] is built with data in mind and being able to recognize the acuity of your patient, the improvements you’ve made, reduction in hospitalizations, improving quality of life and all those metrics we look at from an operator’s perspective.”
Ultimately, proving those outcomes will lead to greater adoption of the service, Rose says.
“Palliative care fits all the macro health care quality goals. It will be really nice to be able to say, ‘This is evidence-based palliative care.’ Defining that and characterizing that is going to be really important. It’s making waves. It’s proving outcomes. It’s getting a lot of attention, as it should be.”
Editorial Note: This article was originally published on Hospice News.