4 Examples Of Better End-of-Life Care

by Alicia Caramenico

April 16, 2018

Health insurance providers across the country are improving care for patients with serious illnesses.

Advances in medicine mean that people are living longer. In fact, according to a report from the National Institute on Aging, the number of Americans age 65-and-over will nearly double by 2050 to 88 million. It’s great news that people are living longer, healthier lives. And they’re living better when they’re ill.

As our population ages, it’s no surprise that the need for palliative and end-of-life care is growing faster than the system’s ability to provide. A study from the Center to Advance Palliative Care notes that today 67 percent of U.S. hospitals with 50 or more beds also have palliative care teams, and Medicare has been reimbursing for advance care planning since 2016. Palliative care has been shown to improve quality of life for patients with serious illnesses—reducing pain, relieving caregivers, prolonging life, and even lowering health care costs. Yet staffing is a problem. Some estimates say that staffing levels fall short somewhere between 6,000 and 18,000 providers.

Training more specialists is a start. When primary care providers are trained in end-of-life care, patients can learn about their options and make informed care decisions. Yet, in a 2016 survey commissioned by The John A. Hartford Foundation, Cambia Health Foundation, and California HealthCare Foundation, only 29 percent of physicians reported having any formal training in end-of-life care discussions.

End-of-life care plans can simultaneously improve patient satisfaction and the efficiency of care delivery. Health insurance providers are working to expand access to these services. For example:

  1. The Cambia Health Foundation’s “Sojourns” program provides grants to projects that focus on workforce development and increasing awareness of and access to end-of-life care services.
  2. Regence updated its policies to include a palliative support benefit for all of its 1.7 million members.
  3. Cigna is piloting a collaboration with Aspire Health to provide in-home palliative care services to members in three states.
  4. Blue Shield of California expanded its home-based palliative care program statewide. It found that 90 percent of those enrolled in palliative care who passed away did so at home, according to their wishes.

When recovery or cure are not the objective, how do you define successful outcomes and measure the quality of end-of-life care? Health insurance providers are building an evidence base for palliative and end-of-life care, including working to establish how to define and measure successful outcomes. This is a particular challenge when the metrics—such as comfort and atmosphere—can be very subjective. The growing body of research will enable health plans and providers to make sound and consistent decisions, satisfy patients, and build a pipeline of facilities and providers to meet this growing need.



To join the discussion on end-of-life care and learn what health insurance providers are doing to meet the needs of patients with advanced illness, register for AHIP’s Institute & Expo, June 20-22 in San Diego.