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Avoiding Spending While Meeting Patients' Wishes: A Model of Community-Based Palliative Care Uptake in California
Eric R Kessell1, Richard M Scheffler1, Stephen M Shortell1
1Division of Health Policy and Management, School of Public Health, University of California , Berkeley, Berkeley, California.
Background:
Community-based palliative care can improve outcomes and avoid unnecessary spending, but the effects of its widespread adoption on health care spending in California is unknown.
Objective:
To estimate the spending avoided if, by 2022, more than 100,000 Californians received community-based palliative care (CBPC) per year.
Design:
We estimated the 6-month per-patient spending avoided through three mature CBPC programs in California and extrapolated data to predict the total avoided spending statewide over 8 years if enrollment in the three programs proceeded according to our model.
Results:
If Californians participated in CBPC in the numbers envisioned, in 2014 there would have been a $72 million reduction in intensive hospital based care, while still respecting patients' wishes, and nearly $1.1 billion in spending could be avoided in 2022. Overall hospital spending would be reduced by more than $5.5 billion through 2022.
Conclusions:
Existing CBPC programs have the potential to provide care that is both in alignment with patients' wishes and avoids substantial amounts of unnecessary hospital-based spending.
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