Beyond Billing: Covering Costs and Generating Revenue
Most programs combine several funding sources that can include billing revenue, investment by the home organization, partnership with health plans, and/or grants and philanthropy. Use this toolkit to learn the fundamentals of payment, fee-for-service billing strategies, and other basics of securing revenue.
What’s in the Toolkit
Introduction to Payment
The basics of health care payment and implications for palliative care.
Monograph introducing U.S. health insurance with a focus on Medicare and what it means for palliative care.
Defines key terms in payment vocabulary.
Federal website explaining the basics of value-based payment, with explanations, patient stories, and payment model summaries
Fee-for-Service Billing
Palliative care is reimbursable as professional medical services. These tools can help you optimize your billing.
In this on-demand webinar, Phil Rodgers, MD, and Chris Jones, MD, MBA, offer an update on changes to billing and coding for 2024, with new codes that can create a revenue stream for a fuller, wrap-around palliative care program.
Toolkit with billing and coding best practices for palliative care services delivered in the hospital or the community.
An at-a-glance listing of all wRVUs relevant to palliative care.
At-a-glance Medicare RVUs and national non-facility payments for codes commonly used by community-based palliative care programs.
In this Virtual Office Hour, expert faculty will explore commonly asked inpatient palliative care billing questions and describe billing and coding practices.
In this Virtual Office Hour, ask questions about billing for services provided in the home, office, or long-term care setting.
Value-Based Payment
Some palliative care programs participate in value-based payment, either directly with a payer or indirectly with another provider or ACO. These tools can support value-based payment arrangements
Overview of the payment arrangements that currently exist for palliative care services.
Monograph introducing value-based payment and its implications for palliative care.
Monograph outlining the leadership and operational competencies that palliative care teams need to succeed under value-based payment.
Introduction to building partnerships that can financially support palliative care programs.
Navigating financing strategies for hospice-led palliative care, including Medicare fee-for-service, payment contracts, organizational support, and philanthropy.
Resources for palliative care programs working with payers and other financial collaborators, including contracting resources.
Financial blueprint for supporting rural services. Stratis Health.
Foundation Fundraising Guidance
New initiatives to improve the care for people with serious illness can often match a foundation's goals. Use these resources to sharpen your fundraising knowledge and skills
Listen in on a conversation providing insights on foundation fundraising for palliative care initiatives, particularly those focused on improving care for underserved populations. CAPC’s Chief Health Transformation Officer, Allison Silvers MBA, is joined by program officers from two local foundations, one national foundation, and a successful grantee. Hear their advice for finding, approaching, and working with funders.
An at-a-glance overview of best practices in proposal preparation
Ideas and information to inform an initial letter of inquiry for an initiative that advances racial equity during serious illness
A presentation clarifying how to present and request philanthropic funding for your palliative care program.
This six-step worksheet will assist in developing key messages to engage your development office and your potential donors to secure philanthropic support.
Includes 48 resources:
- 2025 Medicare Billing Updates
- The Basics of Palliative Care Billing: Foundational Concepts, E/M Codes, and Telehealth
- Advance Care Planning (ACP)
- Addressing Social Needs and Caregiver Support
- Billing for Care Management and Navigation Services
- Care Plan Oversight (CPO)
- High-Complexity Patients
- Billing for Palliative Care in the Intensive Care Unit (ICU) and the Emergency Department (ED)
- Relative Value Units (RVUs)
Includes 10 resources:
- Hospital-Based Program Staffing and Budget
- Community-Based Program Staffing and Budgeting
Includes 14 resources:
- Relationship Basics
- Selling Your Program
- Contracting Resources