Innovations in Palliative Care for California’s Seniors

The Need

California’s senior population is expected to grow by four million people through 2030. With many seniors facing challenges associated with serious illnesses, expansion of palliative care models into the home and community have great potential to help those seniors maintain independence and improve their quality of life while preserving dignity.

What Is Palliative Care?

Palliative care is a medical specialty focused on improving quality of life and managing symptoms for people facing serious illness such as cancer, diabetes, stroke, heart and lung disease, Parkinson’s disease, Alzheimer’s disease and more. Palliative care is not only end-of-life care, it is appropriate concurrently with curative treatments upstream from hospice care. While Medicaid, Medicare, and private insurance generally cover hospice care, coverage of palliative care is limited.

Effective palliative care, in both a hospital and home setting, has been shown to not only improve patient quality of life, but also saves money and resources on overall patient care. Its expansion should be further explored in California and around the country.

Taking Action

Through a combination of applied medical research, supportive policy, effective advocacy and outcomes-based philanthropy, West Health is working to create and foster new integrated care models that improve health outcomes and better address both the medical and non-medical needs of seniors and their families. The West Health Institute, West Health Policy Center and Gary and Mary West Foundation all work together under the umbrella of West Health with a shared mission to enable successful aging for our nation’s seniors. Among other research initiatives, West Health is working to advance solutions that improve care transitions, produce better patient outcomes and increase efficiency to help enable older adults living with chronic conditions to receive care on their own terms in the setting of their choosing.

West Health’s Efforts in Palliative Care Include:

Research into Effective Palliative Care Models

West Health has partnered with the Mount Sinai Health System on a five-year research project focused on creating, delivering and evaluating a clinical model which provides palliative care to patients in their home. Using the Mount Sinai Health System as a pilot, the program will demonstrate proof of concept for a model that identifies the appropriate patients for palliative care, clinical pathways for delivery of care using community health workers and access to telemedicine. As part of this work, West Health is developing a playbook, with a targeted completion in 2019, outlining how health systems can adopt this model within their system.

Palliative Care Education

Since 2016, West Health has partnered with the California State University Institute for Palliative Care to co-host a nationally recognized symposium for palliative care education and research with the goal of improving the quality of care for the country’s most seriously ill patients.

Integrating Palliative Care with Health Plans

In 2018, West Health engaged with Blue Shield of California, a health plan currently contracting with its providers across the state to deliver palliative care to seriously ill individuals as a benefit within its plan, to independently evaluate the program and identify the return on investment of implementing an in-home palliative care program within a health plan.

Other Research On Palliative Care:

  • A Cambia Health Foundation-supported poll found that more than 78 percent of respondents believe palliative care and end-of-life treatment should be part of the public discourse, and 93 percent said they believe such decisions should be a top priority for the U.S. healthcare system.2
  • According to a study reported in the New England Journal of Medicine, lung cancer patients receiving early palliative care had less depression, improved quality of life and survived 2.7 months longer.3
  • According to JAMA Internal Medicine, in a 2010 study of eight hospitals, effective palliative care programs resulted in thousands of dollars in savings per patient, including significant reductions in pharmacy, laboratory, and intensive care unit costs.4
  • According to a Journal of Palliative Medicine study, a tested home-based palliative care program demonstrated improved outcomes for patients in analysis of cost, hospital admissions, and hospice utilization — and saved up to $12,000 per patient.5
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