When is palliative care not palliative care? How vital is nomenclature? As the healthcare continuum and payment reform evolves, palliative care providers must re-evaluate what constitutes the essence of palliative care and how the care model can best adapt. Without a federal benefit currently defining palliative care, as it does for hospice, there is great variation in care models which causes many disadvantages. However, it also creates opportunities. Providers can hold on to the core of palliative care while specializing the services to best meet the needs of their stakeholders, including their patients, families, partnered providers, and payers.
The Guiding an Improved Dementia Experience (GUIDE) Model from CMMI is one such opportunity. GUIDE is not technically palliative care. But it calls for many of the core services that palliative care provides. Specifically, it calls for meeting the holistic needs of the patient through an interdisciplinary team, providing education and respite for the caregivers, keeping the loci of care in the home, aiding in transitions, being available 24/7, and addressing social, behavioral, and functional needs through community support. Who better than palliative care providers to deliver such services? Given the payment structure, providers will need to adapt to keep services efficient and sustainable, such as adopting technology and data capabilities to manage this population effectively. But it will create continuity of care for this seriously ill population, as well as build the relevance and networking opportunities for provider organizations. Whether palliative care providers enroll in GUIDE directly or through contracts with other GUIDE providers, there is opportunity here to build service lines, diversify revenue streams, and build costumer pipelines. Being able to apply the strengths of palliative care to new care models, no matter how they are labeled, will empower providers to take advantage of new payment models, especially within value-based care. The palliative care field needs to move into innovation, adaptation, specialization, and collaboration. If not palliative care, other providers will move into this space and the opportunity will be lost.
“Where Palliative Care Fits into CMMI’s GUIDE Model for Dementia Care” by Jim Parker, posted by Hospice News on September 29, 2023, and accessible at https://hospicenews.com/2023/09/29/where-palliative-care-fits-into-cmmis-guide-model-for-dementia-care