Palliative Care in the Post Acute Care Industry
This article discusses what palliative care is, why it’s important in the home healthcare industry, and some differences between palliative, home health, and hospice care.
What is Palliative Care?
According to The Center to Advance Palliative Care: “Palliative care is provided by a specially-trained team of doctors, nurses and other specialists who work together with a patient’s other doctors to provide an extra layer of support. Palliative care is based on the needs of the patient, not on the patient’s prognosis. It is appropriate at any age and any stage in a serious illness, and it can be provided along with curative treatment.”
Why Palliative is Important
Did you know:
- “It is estimated that globally only 14% of patients who need palliative care receive it” (WHO.com).
- “Numerous studies show that palliative care significantly improves the quality of life and lowers symptom burden”(capc.org).
The line between Hospice and Palliative can be blurred at times; however, like Hospice care, Palliative care focuses on improved quality of life for those with complex needs.
Palliative is beneficial in the home healthcare industry. It creates a comfortable environment for patients who have severe or chronic illnesses. The caregiver’s goal is to help the patient manage symptomatic pain and discomfort and the complex physical and emotional symptoms typically experienced with chronic diseases while concurrently addressing curative efforts.
Although Palliative has seen significant growth in the last 15 years, more attention and support for this necessary level of care is needed. “Today, more than 1,700 hospitals with 50+ beds have a palliative care team, and palliative care is spreading beyond the hospital into community settings where people with serious illnesses actually live and need care” (www.capc.org). Despite this growth, expansion of Palliative care is needed in the home health setting. Servicing only 14% of people that need it is inadequate.
Hospice vs. Palliative vs. Home Health
While Hospice care and home healthcare’s definitions are relatively well understood, the definition of Palliative continues to evolve.
Below are three summaries of what each care type does and why each one is essential to in-home healthcare:
Hospice: A patient is admitted to Hospice when without further medical intervention, they will likely not survive longer than six months. Hospice care requires the patient to submit a notice of election confirming their awareness of their terminal prognosis. The Hospice benefit doesn’t support any curative care. Hospice caregivers take care of the patients physically, psychologically, and spiritually as their disease progresses and provide education and support for family members and other bereaved people.
Palliative: Unlike Hospice care, Palliative focuses on the patient’s needs rather than their diagnosis. “Palliative care sees the person beyond the disease. It is a fundamental shift in health care delivery”(capc.org). Palliative is pro-curative, meaning the caregivers provide curative treatments to the patients, whereas Hospice doesn’t.
Home Health: A patient may be eligible for Medicare in-home services when they have achieved the entrance age of 65 or have qualified for Medicare disability benefits. For non-disabled patients younger than 65, there are multiple payer sources for in-home care, including private insurance, self-pay, Medicaid, VA, and more.
For patients to receive in-home care under Medicare and some insurances, they must meet eligibility requirements for Home Health care:
- Must be homebound
- Have a skilled need
“As part of a patient’s certification of eligibility, a doctor, or certain health care professionals who work with a doctor (like a nurse practitioner), must document that they’ve had a face-to-face encounter with the patient (like an appointment with a primary care doctor) within required timeframes and that the encounter was related to the reason the patient needs home health care” (medicare.gov).
For Medicare, the episode length is 60 days, and a Plan of Care is created for each episode after HH RN, PT, etc., assess the patient and a doctor signs off. The patient may be discharged early if all the goals are met or are no longer eligible for benefits. However, if goals are not met, or new issues arise and additional time is needed, the clinician will perform a recertification assessment, a new POC is created, and the physician signs off on the POC.
As stated above, Palliative care’s definition is ever-evolving. However, we do know that Palliative is important because, per WHO, “only 14% of people who need palliative care actually receive it.” More people need to be aware and understanding of Palliative care and its role within the home healthcare and hospice market.
KanTime hosted a table talk led by industry experts on Palliative.