CEPAC meeting affirms the value of outpatient palliative care, but more research is needed

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At yesterday’s meeting in Hartford, CEPAC took a deep dive into the clinical and cost effectiveness of palliative care delivered in outpatient settings.

From CEPAC’s report, “Palliative care is a management approach that provides symptom relief and comfort care to patients with serious or life-threatening illnesses, with the goal of improving quality of life for both patients and their families. Unlike hospice care, which is typically restricted to individuals with a prognosis of survival of six months or less, palliative care can begin at diagnosis and is often provided along with treatment aimed at prolonging life, such as chemotherapy or radiation for cancer.  One of the primary objectives of palliative care is to help patients prioritize their goals of care, and may include conversations around advance care planning (e.g., a “living will”) depending the anticipated disease trajectory.”

The group voted unanimously that there is evidence to demonstrate some forms of outpatient palliative care treatment are effective at improving the quality of life and reducing hospitalizations and ED use. The majority also voted that outpatient palliative care is a high value treatment. But members expressed concern that more research is needed to persuade payers to cover it. Other concerns included workforce capacity challenges, time for training busy primary care providers in palliative care, and teasing out which parts of the model are critical to success. Aetna described their successful Compassionate Care program which has an impressive record of improving the quality of life for people and their families facing serious illness, as well as saving money.

Evidence is growing that palliative care can prolong life as well as support patients who choose to remain home. For more on the issue, read CEPAC’s Palliative Care: Barriers, Opportunities and Considerations for Quality Improvement.