Health Plan Medical Directors: Supporting Best Care for Members with Serious Illness
Last Reviewed: March 4, 2019
Symptom management, communication about care preferences, and family support result in fewer crises and less reliance on emergency department and hospital care for people with serious illness.
Health plan medical directors can improve quality of care for members with serious illness through collaboration with both treating clinicians and health plan care managers to help match services to needs.
Download a course catalog with information about continuing education credits and ABIM MOC points for all CAPC courses here.
What’s in the Toolkit
Opportunities to Improve Value in the Care of Health Plan Members with Serious Illness
Strategies for health plans and Accountable Care Organizations (ACOs) to promote access to palliative care services through collaboration and contracting with providers.
Communicating with Treating Clinicians: How Medical Directors Can Support Best Care for the Seriously Ill
Last Updated: October 19, 2017
Guidance for collaborating with treating providers to ensure that members who would benefit receive palliative care.
start the courseSerious Illness Strategies
Last Updated: February 3, 2019
The 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.
downloadAn In-Depth Look At Palliative Care And Its Services
Last Updated: January 15, 2015
Defining palliative care, which patients need it, how it is delivered, and how palliative care differs from hospice.
start the courseIntroduction to Palliative Care in the Community
Last Updated: January 15, 2015
Defining community-based palliative care: which patients need it, how it is delivered, and how it differs from inpatient palliative care.
start the courseNational Consensus Project for Quality Palliative Care, 4th edition
Last Updated: January 29, 2019
The National Consensus Project (NCP) Clinical Practice Guidelines are the national standard for high quality palliative care. National Consensus Project for Quality Palliative Care, 2018.
viewImproving the Care of Serious Illness Though Innovative Payer-Provider Partnerships- A Palliative Care Toolkit and Resource Guide
Last Updated: January 29, 2019
Designing a payer-based program that ensures specialized support for members with serious illness. Center to Advance Palliative Care, 2016.
downloadIdentifying Older Adults with Serious Illness- A Critical Step Toward Improving the Value of Health Care
Last Updated: February 6, 2019
An evidence-based algorithm for identifying members at high risk for subsequent hospitalization. Kelley AS, Covinsky KE, Gorges RJ, et al. Identifying Older Adults with Serious Illness: A Critical Step Toward Improving the Value of Health Care.Health Serv Res. 2017;52(1):113-131. doi: 10.1111/1475-6773.12479.
downloadCare Delivery and Coordination in an Accountable Care Environment
Last Updated: February 3, 2019
Improving value by integrating palliative care into ACO strategy. Block S, Jackson V, Lee T. Health Affairs Blog, February 2014.
viewNCCN Clinical Practice Guidelines for Oncology: Palliative Care
Last Updated: January 6, 2020
An integrated, evidence-based suite of tools developed by the National Cancer Care Network designed to help improve the quality of cancer care.
viewNHPCO Standards of Practice for Pediatric Care and Hospice
Last Updated: January 6, 2020
An overview of the standards for high-quality palliative care for children.
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Concurrent: Negotiating Conflicts between Palliative Care and Other Providers: Why Can’t We All Just Get Along?
Last Updated: February 28, 2019
2010 CAPC National Seminar presentation. Presenter: Robert Arnold, MD
members loginAddressing Pain and Symptoms
Clinical guidance specific to the population of people with serious illness.
Symptom Management
Last Updated: March 4, 2019
Training curriculum and clinical tools for assessing and managing five common symptoms in patients living with serious illness.
viewCourse 1: Comprehensive Pain Assessment
Last Updated: July 1, 2019
Conducting a comprehensive pain assessment to guide safe and effective treatment.
start the courseCourse 3: Patient Factors that Influence Prescribing Decisions
Last Updated: July 1, 2019
Patient and family factors that influence prescribing decisions for patients with serious illness.
start the coursePalliative Care Guidelines and Order Sets (ICSI)
Last Updated: February 3, 2019
A comprehensive approach to addressing the pain and symptoms of serious illness. Prepared by the Institute for Clinical Systems Improvement, 2007.
viewAligning Care with Patient Values
Support both treating clinicians and health plan care managers to elicit and address what matters most to members and families.
Supporting the Family Caregiver: The Burden of Serious Illness
Last Updated: March 10, 2016
Assessing and supporting caregivers of people with serious illness.
start the courseAdvance Care Planning Conversations
Last Updated: November 12, 2015
How to initiate and conduct conversations about advance care planning.
start the courseClarifying Goals of Care
Last Updated: January 15, 2015
Strategies for eliciting patient goals and preferences to inform treatment decisions.
start the courseAdvance Care Planning Resources (CCCC)
Last Updated: March 1, 2019
A suite of tools developed by the Coalition for Compassionate Care of California, including conversation guides and several advance directive forms, the latter also in Spanish.
viewThe Human Connection of Palliative Care: 10 Steps for What to Say and Do
Last Updated: February 3, 2019
Ten important steps for improving communication between clinicians and patients/families. NOTE: This video does not provide CE credits.
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