Because CPR typically works with employers seeking to improve the value of the health care they buy for an employee population, we tend to focus on cost drivers impacting the workforce. For this reason, issues like end-of-life planning and palliative care are not always top of mind for us despite knowing how critical they are for the system overall.
However, we took another look at how palliative care fits into a health care strategy today, especially as employers seek ways to manage their highest cost claimants.
Why is palliative care important for employers?
A 2011 study showed that the top 5% of heath care spenders accounts for 60% of costs. What is driving this spending? Some have a misconception that the bulk of this spending occurs during end-of-life, but this accounts for only 11% of these costs. The vast majority of this spending comes from patients who have acute care needs (49%) or ongoing chronic diseases resulting in high costs (40%).
Palliative care, by definition, is specialized medical care for anyone suffering from a serious illness, and thus can improve quality of life for patients of any age with a range of conditions. A 2014 report written by the National Business Group on Health cites that it is the population of patients who are sick year after year that “represent the highest-leverage opportunity for improving value in the health care system.” This number is on the rise due to an increased aging population of baby boomers and the fact that new technologies and medicines are allowing people to live longer with chronic conditions.
What are the benefits of palliative care?
Palliative care practices can provide the patient with a significant survival advantage. Patients consistently report finding more comfort and support with palliative care than without it. With better all-around care, pain management, and a managed care plan in place, patients are less likely to require hospital stays, emergency services, ICU stays and ancillary care. For example, Aetna’s Compassionate Care program resulted in $12,000 in savings per member due to these reductions.
Additionally, palliative care reduces stress on care givers and reduces unnecessary diagnostic imaging and therapies that may not provide added benefit and may actually increase harm. According to a 2015 study by Health Services Research, “By better matching treatment plans to patient goals and providing support where it is needed, palliative care has been shown to reduce the need for unnecessary and unwanted services.”
What can you do?
Purchasers have tremendous leverage in the market to demand certain capabilities from contracted health plans, vendors, and health care providers can make a direct and significant improvement in the quality of life of employees living with serious illness and their caregivers.
CPR and CAPC have created a suite of tools to give employers and other health care purchasers resources and technical assistance for implementation of strategies to assure reliable access to high-quality palliative care.