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 about financing strategies for inpatient and community-based programs, designing a business plan and budget, building financial partnerships, and operating efficiently so as to control costs while delivering high-quality care.

What’s in the Toolkit

The basics of health care payment.

Payment Quick Tips: Understanding Medicare, Medicaid, and Commercial Insurance
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Monograph introducing U.S. health insurance with a focus on Medicare and what it means for palliative care.

Payment Quick Tips: Value-Based Payment Introduction
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Monograph introducing value-based payment and its implications for palliative care.

Payment Glossary

Defines key terms in payment vocabulary.

Financing methods for the palliative care program, including billing revenue, investment by the home organization, partnership with health plans, and/or grants and philanthropy. To learn how to make the case to financial stakeholders, see the related CAPC toolkits at the bottom of this page.

Optimizing Billing Practices

Toolkit with billing and coding best practices for palliative care services delivered in the hospital or the community.

Tools for Making the Case

These tools can be used to make the case for palliative care investment with organization leaders, health plans, colleagues, and community partners.

Philanthropy Strategies
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A presentation clarifying how to present and request philanthropic funding for your palliative care program.

Payment Arrangement Options

List of payment models that have been used for community-based palliative care services, along with their pros and cons for providers.

Quick Tips: Financing Your Community-Based Palliative Care Program
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Navigating financing strategies for hospice-led palliative care, including Medicare fee-for-service, payment contracts, organizational support, and philanthropy.

Alternative Payment for Palliative Care: Getting from Here to There Webinar Recording
Value-Based Payment: Building a Financially Sustainable Palliative Care Service

Tools to develop financial partnerships including: making the case, contracting considerations, and how to use legal and financial advisers.

Sustainability Strategies for Community-Based Palliative Care

Financial blueprint for supporting rural services. Stratis Health.

A sustainable business plan depends upon making realistic assumptions about patient volume and staff capacity.

Hospital Patient Volumes and Characteristics Worksheet
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Estimate patient volume using national comparative data from the CAPC National Palliative Care Registry. Center to Advance Palliative Care, 2015.

Hospital Palliative Care Program Staffing Worksheet
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Project staffing FTE per discipline based on expected patient volumes. Center to Advance Palliative Care, 2015.

Using service volume and staffing estimates to project program costs.

Hospital Palliative Care Impact Calculator

Free, interactive tool to help you estimate savings attributable to your hospital palliative care team.

Financial Analysis and Budgeting Tool for Community-Based Palliative Care
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Customizable workbook for community-based programs to create cost projections and key financial stats.

Understanding Costs and Prices: Companion Guide for Financial Analysis and Budgeting Tool
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Qualitative explanation of budgeting and finding opportunities for cost-efficiency.

Translate service, staffing, cost, and billing revenue projections into a budget and business plan.

Building the Business Plan for Your Hospital Program

Building a budget and a business plan for the inpatient program. Includes business planning tools.

Hospital Palliative Care Business Plan Outline
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Training and a template for creating a business plan for your inpatient service.

Budget Model Worksheet
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Annotated budget worksheet that can be customized based on your program's patient, service, and staffing assumptions.

Building the Business Plan for Community-Based Palliative Care

Building a budget and a business plan for the community-based program. Includes business planning tools.

Business Plans for Community-Based Palliative Care: Principles to Guide Development of a Sustainable Program

Presentation on business planning fundamentals.

Meet quality standards while optimizing efficiency in order to meet the assumptions you have laid out in your business plan.

Maximizing Palliative Care Program Efficiency

Improving productivity and efficiency to ensure team health and operating within budget.

Guidance for contracting with health plans or other entities to secure funding your palliative care program.

Payment Quick Tips: Payment Partnerships
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Introduction to building partnerships that can financially support palliative care programs.

Payment Quick Tips: Value-Based Payment Capabilities
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Monograph outlining the leadership and operational competencies that palliative care teams need to succeed under value-based payment.

Tips for Hiring Lawyers and Actuaries / Financial Advisors
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How to find and select key consultants for financial relationships.

Simple Rules for Making Alliances Work
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Harvard Business Review on developing and nurturing business relationships.

Advice from the Inaugural CAPC Payment Accelerator Class
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Lessons from CAPC Payment Accelerator alumni on building financial relationships with health plans.

Key Contract Provisions for Payment Contracts
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Key contract clauses including term, termination, quality reporting parameters, and risk corridors.

Regulatory and Licensure Considerations for Community-Based Palliative Care
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Compliance issues and considerations for programs working with financial partners.

Contract Protections for Downside Risk
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Contract strategies and protections for reducing downside risk, such as exclusion of outliers and stop-loss provisions.

Template Memorandum of Understanding (MOU)
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The "Memorandum of Understanding" (MOU) is a brief document that outlines mutual responsibilities. Follow this outline to draft an MOU (must be reviewed by legal counsel).

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