Resources for Health PlansLast Reviewed: March 4, 2019
Access to palliative care services results in improvement on quality measures, reduction in spending, and relief of suffering for members and their families. In addition to the general guidance and case studies available in CAPC’s Population Management and Palliative Care toolkit, health plans can use the resources below to develop new programs and benefits for members with serious illness while simultaneously driving improvements throughout their provider network.
What’s in the Toolkit
Specialty Palliative Care Services and Benefits
Guidance and tools to ensure access to specialty palliative care services for members living with serious illness.
Guidance on Benefit DesignLast Updated: February 3, 2019
Modifying existing benefits and adding new benefits.download
Payment Arrangements OptionsLast Updated: February 3, 2019
Overview of the payment arrangements that currently exist for palliative care services.members login
Medicare Advantage Flexibility: Improving Care for Seriously Ill BeneficiariesLast Updated: February 3, 2019
Specific actions for plans looking to improve value-based design or expand supplemental benefits. Health Affairs, July 2018.view
ROI Calculator for a Home-Based Palliative Care ProgramLast Updated: February 3, 2019
Calculates return on investment, based on the home-based palliative care program assumptions. CAPC Payment Accelerator, reviewed 2018.members login
Building an Actuarial Model for Home-Based Palliative CareLast Updated: February 3, 2019
Presentation to Society of Actuaries on calculations for case rate payment.members login
Purchaser Toolkit for High-Quality Serious Illness CareLast Updated: February 3, 2019
Tools for employers and other stakeholders to specify required benefits and network competencies. Catalyst for Payment Reform and Center to Advance Palliative Care, 2018.view
Provider Network Strategies
Resources for identifying in-network or regional palliative care specialists, and for improving the communication and symptom management skills of all network providers.
Guidance on Provider Network StrategiesLast Updated: February 3, 2019
Improving network competencies and identifying palliative care specialists.download
Guidance on Payment and IncentivesLast Updated: February 3, 2019
Implementing network competency incentive programs and paying for specialty palliative care.download
Recommended Standards for Hospitals and SNFsLast Updated: January 29, 2019
Structures and processes that all hospitals and skilled nursing facilities need to assure access to high-quality care for people with serious illness.download
Innovative Approaches to Caring for Complex Patient Populations: The Community Paramedicine ExperienceLast Updated: February 26, 2019 watch
Identification and Case Management Strategies
Tools and protocols for proactively identifying rising-risk members with serious illness, and improving case management interventions to ensure the right services at the right time for members living with serious illness.
Patient Identification and AssessmentLast Updated: March 4, 2019
Toolkit for finding the right patients at the right time to address gaps in care.view