Palliative Care Sustainability Through Strong Fundamentals

Taking actions in areas the palliative care team has control over creates certainty during uncertain times. Focusing on the fundamentals of program management and operational effectiveness help stabilize the team, and demonstrate program responsiveness and accountability to the organization.

Here are four places to start:

The ongoing challenges within the U.S. health care system require organizational leaders to adapt and make decisions in response to the ever-changing landscape, which means that now is the time to engage.

The goal: Prove that you are a problem-solver and a collaborator.

Where to start:

Use this list to think about which goals your leaders and colleagues may be focused on during times of change.

Meet with your strategic partners to understand their priorities, so you can plan your palliative care strategy accordingly. CAPC provides guidance on who to talk to, what to ask them, and how to put your best foot forward.

Optimizing Appropriate Billing

Being a good financial steward of your palliative care program means ensuring appropriate revenue for the services you provide. Ask yourself: Is the program accurately documenting and billing for its services?

• Do I have the billing reports I need to audit the program's billing and coding practices?
• Do I meet regularly (quarterly) with the billing team to review our billing data and strengthen relationships?
• Is our program optimizing all of the appropriate billable services?

Where to start:

CAPC's Billing and Coding toolkit has information on specific codes, including for advance care planning (ACP), non-face-to-face, care management and care plan oversight, and setting-specific billing and coding.

Join upcoming Virtual Office Hours on inpatient and community-based billing.

Is your program using telehealth? Download our telehealth billing guide to learn best practices.

Alternate Sources of Program Revenue

Fee-for-service billing does not cover the full costs of an interprofessional palliative care team. If you haven't considered contracting for your services with a health plan or risk-bearing entity in the past, now is the time—and CAPC has the tools to help.

Start with Quick Tips for Payment Partnerships, and for more information, explore CAPC's Contracting to Finance Palliative Care Services toolkit.

A high-performing team continuously looks at issues like team communication, role clarity, and workflow to openly address barriers and make sure everyone is operating at the top of their license and skills. If the team is working well together, you’ll make best use of resources and prevent burnout and turnover.

• Are we using our team meetings efficiently?
  • CAPC Tool: Running Effective IDT Meetings
• How well is our team communicating throughout the day?
  • Watch CAPC's Team Communication webinar on your own, or as a team
• Can we use telehealth to maximize time?
  • The Telehealth Toolkit covers all aspects of palliative care telehealth delivery, including selecting the technology platform, setting up a hotline, billing for services, and conducting a visit.
• Are you actively managing your census? Do a self-assessment to answer:
  • Are we seeing the right patients?
    • Review your referral criteria and consider options for making them more systematic
  • How can we grow earlier referrals from key collaborators (e.g., hospitalists, cardiology, oncology)?
  • Are we following patients too long? Or not long enough?

Ongoing health care challenges strain palliative care teams, making proactive support essential to build resilience and prevent burnout.

Where to start:

• Watch CAPCs On-Demand Webinar, “Can I Still Call You?”: Navigating Termination in Clinical Practice. In psychotherapy, termination marks the intentional close of the patient-clinician relationship, supporting both patient outcomes and clinician sustainability.
• Review the Health Care Professional Well-Being toolkit and consider holding debriefing sessions at your organization.
• Attend one of CAPC's Virtual Office Hour Breaking Point: Debriefing to Address the Challenges of Our Work. These unique, informal, facilitated discussions where you can share common reactions to your demanding work and coping strategies that can diminish the consequences of this stress.