Palliative Care: Right for the Patient and the Right Thing to Do

By Zaundra Ellis, Senior Director of Hospice and Palliative Care Solutions, Axxess

At the height of the pandemic, patients were going to emergency rooms or hospitals that did not have space for them, and nurses were admitting many who were ill and dying in a matter of days. Clinicians were doing the heavy lifting of admitting a patient, and then having to turn around and perform a death visit. This created a challenging cycle that sapped time, energy and resources. This lasted about a month, leaving behind burnt-out staff and little revenue.

Now, as the pandemic has taken more than seven hundred thousand lives in the United States, hospice care has never been more important. But as COVID-19 persists, hospice providers continue to struggle. A national survey of hospice nurses and physicians found that, due to the pandemic, organizations’ flow of patients is impeded and workforce availability is affected.

Palliative care can bring new growth to organizations that have suffered due to the pandemic, as well as offer services that fit a growing need among patients.

What is Palliative Care?

April, a 65-year-old woman recently diagnosed with stage two colorectal cancer, has begun experiencing several associated symptoms, such as bleeding, persistent abdominal pain, weight loss, nausea, and fatigue. She could benefit from palliative care. 

In fact, even before the pandemic, an estimated 100 million people could have benefited from palliative care if palliative care was more widely known and understood. But for many, the line between hospice and palliative care is a blurry one. Though both types of care offer pain and symptom relief, hospice focuses primarily on end-of life care, while palliative care works to relieve suffering at all stages of a serious disease.

Need for Palliative Care

Across the nation, there is a growing need for palliative care. A large population with a wide array of diagnoses that require this form of care exists, and as the country’s population ages at an unprecedented rate, the number of people to be diagnosed with a serious illness will also swell, further necessitating palliative care.

Diagnoses typically associated with palliative care include cancer, heart disease, AIDS, as well as pulmonary, renal, and neurological diseases. As a matter of fact, the number of cancer cases is projected to more than double worldwide over the next 20–40 years.

Value-Based Payment is No Motivator to Provide Palliative Care

The Value-Based Insurance Design (VBID) Model took effect on January 1, 2021. However, in a survey of hospice and palliative care organizations, 72 percent of respondents communicated that the payment model did not — or will not — influence their decision to provide palliative care. 

This is because those who provide palliative care, whether it is at the senior executive level or whether it is direct caregiving staff, believe in helping people and in providing care and comfort to those who need it. Hospice leaders have a genuine sense of responsibility that people need palliative care, and providing it is the right thing to do.

Palliative Care Makes Sense

And palliative care is the right thing to do because it simply makes sense.

Where palliative provides most is improved quality of life for patients and their families.

A palliative care provider or team works with patients to alleviate pain and minimize suffering. This can be done through treating symptoms such as shortness of breath and nausea, which then improves the quality of life of patients and their families, who may face challenges associated with life-threatening illnesses. Additionally, the palliative care team can function as a conduit between the patient and other providers, which can also relieve stress patients may have as they navigate their many providers.

Opportunity for Innovation

But as palliative care grows in need and practicality, it is important to improve existing models. The most innovative thing that we can do is create more structure around palliative care.

Palliative care is broad, and as noted previously, spans many disease types, as well as ages. Patients can also receive palliative care either in the hospital or at home. While there are no regulatory guidelines specific to palliative care, some bills have been introduced, but palliative care — without defined policies — is in limbo.

Moving forward, we must work to make sure that palliative care providers are reimbursed for the services that they provide. Furthermore, quality is measured at the provider level, so there is no actual quality reporting or requirements around the palliative care organization. The biggest opportunity for innovation is going to be reimbursement and quality measures at the organizational level. 

As palliative care grows in need, these innovations will be paramount in growing the service line itself. People like April, and millions of others, can benefit from palliative care, and many organizations are recognizing its worth. Not just because palliative care can bring new growth, but because it is the right thing to do. 

Zaundra Ellis is the Senior Director of Hospice and Palliative Care Solutions for Axxess. She leverages her many years of expertise in the hospice industry to create software that is easy to use and allows clients to be clinically, administratively, and financially compliant.