CAPC is working to ensure that payment for palliative care and person-centered approaches aligns with the value it generates.
HHS Secretary Alex Azar has affirmed a strong commitment to value-based payment, joining the significant efforts underway among private payers. This is an opportunity for palliative care to be integrated into the standard care for those with serious illness. Shifting from volume-based payment models to alternative payment models creates an environment where improving quality and patient experience, while ensuring appropriate utilization of costly health care services, is not only desired but required—and palliative care has a strong track record on all three counts.
In order to be effective messengers for the integration of palliative care into population management and alternative payment models, CAPC has made important resources available. First, these documents can provide some additional information as palliative care programs seek to secure financial arrangements in addition to, or in lieu of, fee-for-service:
- Tips for Hiring Lawyers and Financial Advisors underscores what kind of professional advice is needed and how to locate reliable advisors
- Payment Arrangement Options describes eight payment arrangements between palliative care programs and their financial partners
- Workflow for Palliative Care Providers highlights the processes to be followed to secure and sustain a financial partnership, including which functional area needs to be involved in which part of the process
More payment tools and resources are available to CAPC members. Learn more.
The CAPC Payment Accelerator
The CAPC Payment Accelerator is a new initiative to equip palliative care programs with the knowledge and skills needed to secure sustainable financing for community-based palliative care. It begins with an immersive face-to-face workshop held immediately prior to the CAPC National Seminar and continues with access to experts and exclusive resources that support participants over the course of twelve months as they explore opportunities and negotiate partnerships. The areas of focus during the course of the Accelerator program include partnership opportunities, program design and pricing, and contracting and negotiation.
- In-person education with CME/CEUs
- A suite of practical tools for analyses, decision making, and presentations, which enable participants to apply best practices to their particular situations
- Post-workshop mentoring that consists of virtual consulting with legal and financial experts, exclusive webinars, and peer discussions to work through challenges
Payment Primer and Glossary
To integrate palliative care into value-based payment models, providers need to understand how payment works and how palliative care generates value. The CAPC Payment Primer: What to Know about Payment for Palliative Care Delivery provides a basic foundation in health care payment, insurance structure, alternative payment models, and quality metrics. For programs interested in payer-provider partnerships but not sure where to start, the Primer offers ways to identify opportunities for payment improvement. This infographic offers a brief introduction to the process to get you started.
The Payment Glossary of Terms, a companion piece to the Primer, offers better understanding of payment vocabulary.
Members of CAPC can gather more detailed information on business planning and problem solving through the tools and technical assistance available on CAPC Central.
MACRA and the Quality Payment Program (QPP)
Starting in calendar year 2017, any clinician who receives more than $30,000 from Medicare Part B, and bills Part B for more than 100 Medicare beneficiaries annually, must participate in the QPP, which puts a portion of their Medicare payments at risk based upon performance. Learn what this means for palliative care clinicians:
- Check out the National Coalition for Hospice and Palliative Care’s MACRA webinar and slides.
- Review a list of Frequently Asked Questions from peers in the palliative care field, along with the National Coalition's responses.
- Find out more at the QPP website.
In order to improve access to high-value care, payers and providers are working together to find new ways to deliver and finance palliative care. CAPC has developed a Palliative Care Toolkit and Resource Guide designed for organizations that are working to improve health care delivery. The toolkit gathers early best practices in palliative care financing and access, and provides summaries and checklists to get started.
Another important resource for advancing high-value care for the high-cost/high-need population is the Better Care Playbook, an IHI resource, which compiles promising care delivery and financing approaches from across the United States.
CAPC Central Payment Resources
CAPC member organizations can access the full array of CAPC tools, training, and technical assistance on payment through our courses, webinars, virtual office hours, topic-specific discussion forums, curated resources, and more by logging in to CAPC Central. To learn more about becoming a CAPC member, visit our membership page.
NEW! CAPC Payment Primer: What to Know About Payment for Palliative Care Delivery
Download CAPC's newest payment resource for a basic foundation in health care payment, insurance structure, alternative payment models, and quality metrics.Download