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Patient Outcomes ROI in Community-Based Palliative Care

Care at home leaders are continuing to rapidly add community-based palliative care programs to their service lines. While this growth offers a benefit to the community and patients, palliative care is often viewed as a loss leader for organizations. Amy Rose, RN, MSN, CHPN, Product Director at Axxess, shared how patient outcomes can be strong key performance indicators (KPIs) for organizations, even when the financial return on investment (ROI) may not be as strong.

This blog is the third in a series that focuses on actionable ways to define ROI and outlines common palliative KPIs to show impact. Most ROI is tied to financially driven metrics; this blog focuses on patient outcome KPIs that can help define success.

When considering a palliative care service line, organizations should weigh both the short-term and long-term ROI as it relates to patient outcomes and impact on the community.

Short-Term ROI

  • Increased Quality of Life
  • Palliative care can help patients live better lives by managing their symptoms, providing emotional and spiritual support and helping them make informed decisions about their care. In some cases, this may lead to improved life expectancy.

  • Increased Patient Satisfaction
  • Palliative care can help increase patient satisfaction by providing patients with the care and support they need to live their best lives.

“You can translate patient satisfaction to return on investment,” Rose said. “Patient satisfaction can be related to the name you have in the community and how many people trust you with [their] care.”

Organizations that focus on increasing patient quality of life and satisfaction will often experience a more stable palliative-to-hospice pipeline and an increased reputation in the community, leading to more business and opportunities.

Long-Term ROI

  • Reduced Hospital Readmissions
  • Palliative care can help reduce hospital readmissions by providing patients with support, education and care that can help them stay home and avoid complications. Studies of patients with heart failure found that those who received palliative care had better quality of life, less anxiety and a shorter hospital stay than those who did not receive palliative care.

  • Improving Hospice Transitions and Hospice Length of Stay
  • Patients transferring from palliative care to hospice often need less intensive care than those who are admitted to hospice directly from the community. A study by nTakt found that community-based palliative care leads to the highest percentage of hospice transitions. Palliative care patients are often more comfortable moving into hospice care and tend to be more stable. For organizations offering both palliative and hospice services, these patients are also more profitable because they are receiving services for longer periods.

  • Reduced Healthcare Costs
  • Palliative care can help reduce healthcare costs by providing patients with support and care that can help them avoid complications that might require treatment at an acute care facility.

  • Value-Based Contracts
  • Organizations that track healthcare costs and readmission information can use those metrics to help leverage more profitable and sustainable contracts, like value-based Medicare Advantage plans.

“If you can do the work, there is opportunity for value-based contracting to be in place because you’ve already proven those outcomes and there is [a] much [more] reasonable margin in a value-based contract than there is for fee-for-service,” Rose said.

A recent study of palliative care program models completed by the Center for Medicare and Medicaid Innovation (CMMI) found that taking a comprehensive approach to palliative care improved both patient care and quality of life, and the caregiver experience. CMMI cited access to interdisciplinary teams, shared decision-making and home visits as factors that improved the care experience.

Rose also stressed the importance of capturing the patient’s palliative care experience since care is unquantified in the current environment.

Organizations looking to capture the patient’s experience of care can use tools like Consumer Assessment of Healthcare Providers and System (CAHPS) surveys, enabling them to hear directly from patients on the care they’ve received and make changes accordingly. There are several different official CAHPS surveys that can be used in palliative care. These include the CAHPS Clinician and Group Survey (CG-CAHPS) and Primary Care First (PCF) CAHPS.

“There are opportunities in the industry to quantify how well you are managing your patient and their overall care experience and if you aren’t looking at that data, there is opportunity being left on the table,” Rose said.

Axxess Palliative Care, a cloud-based palliative care software, offers a robust suite of reports that can make abstracting and monitoring palliative-specific KPIs easier.

This blog series is written in collaboration with Mark Hendrix of nTakt.


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