Pediatric Palliative Care: Billing and Business Planning
Pediatric palliative care leaders have to consider a number of different funding strategies and opportunities in order to provide comprehensive, quality care. This toolkit provides guidance for designing a business plan and budget, navigating concurrent hospice care, and utilizing effective billing practices.
What’s in the Toolkit
Covering Costs and Generating Revenue
Pediatric palliative care programs use various funding sources to cover their costs. Use this toolkit to ensure your program is utilizing effective fee-for-service billing strategies, and securing long-term revenue.
In this webinar, presenters will share specific and practical guidance on how pediatric palliative care teams can navigate concurrent care hospice billing.
This tracking tool directs palliative care programs to their own state’s regulatory guidance on patient eligibility and service inclusions/exclusions to bill for concurrent services.
In this webinar, presenters will share specific and practical guidance on how pediatric palliative care teams can navigate concurrent hospice billing, and more.
This document covers the importance of a pediatric palliative care business case for sustainability. Considerations include estimating patient volume, funding assumptions, and financial modeling. A worksheet is included to explore how to match your institution’s financial goals with different value propositions.
This poster session discusses a study to create a financing analysis model for pediatric concurrent care or Concurrent Care for Children Requirement (CCCR).
NHPCO developed tools for the Concurrent Care for Children Implementation, including information on the options available to states implementing Section 2302 or considering expansion of pediatric palliative care services.
Fee-for-Service Billing Practices
Pediatric palliative care is reimbursable as professional medical services. The codes that are used for billing are the same for pediatric and adult populations. These tools can help programs optimize billing.
How the interdisciplinary team can bill, and the differences between Advanced Practice Provider (APP) independent and APP 'incident to' or 'shared visits' billing.
This document provides specific details on on time-based vs. complexity billing, including a pediatric case example.
Common CPT Codes with wRVU relevant to palliative care and hospice services across settings with average national payment.
This six-step worksheet will assist in developing key messages to engage your development office and your potential donors to secure philanthropic support.
Staffing, Budgeting, and Business Planning
Guidance, budgeting tools, and templates for pediatric palliative care programs.
This slide deck defines the essential components of business planning for pediatric palliative care. It will help you articulate the value your program will offer and how your program’s service features influence your business plan.
Annotated budget worksheet that can be customized based on your pediatric program's patient, service, and staffing assumptions.
Customizable workbook for community-based programs to create cost projections and key financial stats.
Qualitative explanation of budgeting and finding opportunities for cost-efficiency.
This Virtual Office Hour covers business planning for new or growing palliative care programs across settings.
Faculty
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Lisa C. Lindley, PhD, RN, FPCN, FAAN
Principal Investigator, PedEOL Care Research Group
University of Tennessee, Knoxville -
Sarah Friebert, MD, FAAP, FAAHPM
Director and Founder
Haslinger Family Pediatric Palliative Care Center, Akron Children’s Hospital
Fac… -
Joan “ Jody” Chrastek, RN, DNP, CHPN, FPCN
Pediatric Advanced Complex Care Team Coordinator, FACE-TC research interventionist,
Fairview Home Ca… -
Allison Silvers, MBA
Chief Health Care Transformation Officer
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Lynn Hill Spragens, MBA
Partner
Spragens & Gualtieri-Reed -
Stacie Sinclair, MPP
Associate Director, Policy and Care Transformation
