Payer Strategies and Case Studies
There are many opportunities to integrate palliative care into payers’ existing strategies, including benefit design, provider recognition and care management.
Most options can fit into one or more of five main categories for improving access to palliative care. Learn more by reading the CAPC payer-provider partnership toolkit.
- Community Collaboration and Awareness: Work with community partners (including providers, churches, medical societies and health systems) to build awareness of palliative care and its benefits; strengthen policies, and change public and professional culture regarding shared decision making; and advance care planning together with concurrent palliative care models.
- Provider Training and Recognition: Provide incentives and public recognition for providers pursuing training in palliative care and demonstrating palliative care practices (such as routine documentation of goals-of-care discussions).
- Member Engagement and Care Management: Integrate palliative care practices into member engagement resources and demand- and care-management programs.
- Medical Policies and Coverage: Ensure that palliative care and related services are appropriately defined as medically necessary, and that benefit designs cover palliative care and related services.
- Payment Innovations: Offer payment and incentives to providers that integrate palliative care practices and demonstrate associated quality outcomes.