Population Management and Palliative Care
Last Reviewed: March 4, 2019Organizations working to improve the quality and efficiency of care must focus on their high-need population living with serious medical illness or illnesses. This palliative care toolkit is a collection of practical tools to identify, risk-stratify, and meet the needs of this population.
What’s in the Toolkit
Comprehensive Guidance
Best practices for systematically improving value in the care of people living with one or more serious illness, gleaned from health systems, health plans, and accountable care organizations (ACOs) from across the country. The approach includes proactive patient identification, risk stratification, effective patient engagement and care planning, training and equipping the provider network to meet patient and family needs, and implementing appropriate quality measures and incentives.
Why Population Health and Palliative Care Need Each Other
Last Updated: February 3, 20192016 essay on how palliative care and population health efforts can work best together. Casarett and Teno, 2016.
viewSerious Illness Strategies
Last Updated: February 3, 2019The case for health plans and accountable care organizations to advance access to quality palliative care, and practical guidance for implementation. Center to Advance Palliative Care, 2017.
downloadThe Guide to Integrating Palliative Care into Population Management
Last Updated: February 28, 2019Guidance on the six strategies for implementing high-value care for the population of patients with serious illness, and suggested first steps.
downloadImproving the Care of Serious Illness Though Innovative Payer-Provider Partnerships- A Palliative Care Toolkit and Resource Guide
Last Updated: January 29, 2019Designing a payer-based program that ensures specialized support for members with serious illness. Center to Advance Palliative Care, 2016.
downloadSerious Illness Strategies for Health Plans and ACOs
Last Updated: February 25, 2019Webinar presentation on a population health approach to care for patients with serious illness.
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Communicating with Treating Clinicians about the Implications of Frailty
Last Updated: February 3, 2019Identifying patients with frailty who are at high risk for health care utilization and adverse outcomes.
members loginCase Studies and Resources
Learn from early adopters and jump-start population management efforts using recommended methods for patient identification, risk stratification, assessment, case management, and quality measurement.
Case Study: ProHealth
Last Updated: February 3, 2019ProHealth, a multi-specialty physician practice ACO, uses home palliative care for high-need patients.
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Case Study: Sharp Healthcare
Last Updated: February 3, 2019Sharp Healthcare, an integrated network of hospitals and clinicians, incorporates a home palliative care intervention to meet the needs of complex patients.
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Mini-Case Study: Anthem
Last Updated: February 3, 2019Anthem, a health plan operating across 14 states, includes palliative care structure and process measures in its quality incentive program for network hospitals.
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Mini-Case Study: Partnership Health Plan
Last Updated: February 3, 2019Partnership Health plan, a regional plan in California, uses a small set of outcome measures in its contracts with palliative care programs.
members loginRecommended Standards for Hospitals and SNFs
Last Updated: January 29, 2019Structures and processes that all hospitals and skilled nursing facilities need to assure access to high-quality care for people with serious illness.
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Payment Arrangements Options
Last Updated: February 3, 2019Overview of the payment arrangements that currently exist for palliative care services.
members loginPatient Identification and Assessment
Last Updated: March 4, 2019Toolkit for finding the right patients at the right time to address gaps in care.
viewCase Managers: Addressing the Unique Needs of Patients with Serious Illness
Last Updated: March 4, 2019 viewSerious Illness Strategies for Health Plans and ACOs
Last Updated: February 25, 2019Webinar presentation on a population health approach to care for patients with serious illness.
watch
