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The Business Case for Palliative Care: Translating Research Into Program Development in the U.S
J Brian Cassel1, Kathleen M Kerr2, Noah S Kalman1
1Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia, USA.
Journal of Pain and Symptom Management
|August 23, 2015
Summary
Developing a business model for specialist palliative care (PC) is crucial. Aligning financial incentives with patient benefits can improve care delivery and reduce costs.
Area of Science:
- Health Services Research
- Palliative Care Medicine
- Health Economics
Background:
- Specialist palliative care (PC) often conflicts with U.S. healthcare's revenue-driven model.
- A business case is needed to align organizational financial gains with patient clinical benefits.
Purpose of the Study:
- To identify key principles for a specialist palliative care business model.
- To adapt these principles for both inpatient and community-based PC settings.
Main Methods:
- Review of published studies on palliative care programs.
- Analysis of 15 years of practical experience with PC programs.
- Identification of 10 core principles for a PC business model.
Main Results:
- Established principles for inpatient PC are identified.
- Emerging principles for community-based PC are highlighted.
- Key developments include payer penalties for hospital overuse, alternative payment models (e.g., ACOs), and payer-provider partnerships.
Conclusions:
- A robust business model is essential for sustainable specialist palliative care.
- Adapting models for community-based PC is critical for future healthcare.
- Financial alignment is key to integrating PC effectively into healthcare systems.