CAPC is working to ensure that payment for palliative care and person-centered approaches aligns with the value it generates.
Value-based payments—methods of paying for health care that reward quality and cost appropriateness—made up 38% of all U.S. health care payment by the end of 2015. This trend continues to grow steadily, according to the national Health Care Payment Learning and Action Network.
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.
The CAPC Accelerator
Similar to a business accelerator, the CAPC Payment and Contracting Accelerator will equip palliative care programs with the knowledge and skills needed to secure sustainable financing. The CAPC Accelerator will provide selected programs with an immersive training, practical tools, and year-long mentoring from health plan administrators, financial experts, lawyers, and successful community-based palliative care programs.
The inaugural CAPC Accelerator kicks off with a two-day workshop November 7-8, 2017 in Phoenix, AZ. Application will open February 22.
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.
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 through the National Coalition for Hospice and Palliative Care’s MACRA webinar and slides.
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.