Demonstrate ROI for your Home Based Palliative Care Program Michelle Dahlkemper, RN, BSN, MBA COO Visiting Nurse and Hospice Care of Santa Barbara

Learning Objectives Describe how to determine the community need for palliative care services Describe the importance of defining program goals and target population Identify at least 3 benefits of palliative care that will engage stakeholders and secure reimbursement Effectively use the ROI calculator to build the business case for palliative care in a hospice organization

Current Payment for Palliative Care Palliative Care programs have not historically generated revenue Medicare does not reimburse Medi-Cal (CA) has passed legislation to reimburse Grants and donations Palliative care can generate cost savings for payors Hospices can increase their length of stay and generate income

Potential Payment The Board (or grantor) Payor or Provider Demonstrate Value Collaboration Sustainability Return on Investment (ROI) Payor or Provider Demonstrate Value Quality Improvement Cost Savings Reduced Hospitalizations (30 day readmissions) Reduced ER Visits Reduced ICU days

Developing a Program Research community need Identify Scope of Services Admission criteria late stage illness chronic disease management Staffing model Training and education Metrics, patient experience survey Supportive Materials Referral Forms Collateral Materials

Engage Stakeholders Present a well written proposal or presentation Include information to assist in decision making – data, budget assumptions, payment models Identify cost savings, return on investment, and sustainability Keep slides minimal – be well versed and able to communicate on topic Don’t over promise – keep initial expectations low/reasonable

Simple ROI Calculator

Included Resources Board Presentation Payor Proposal Payor Presentation Scope of Services Referral form Patient Satisfaction Survey ROI Calculator

Additional Resources Center to Advance Palliative Care (CAPC) California Health Care Foundation (CHCF) Coalition for Compassionate Care of California (CCCC) http://www.dhcs.ca.gov/provgovpart/Documents/DHCSPallCareWebinar090816.pdf The California State University--Institute for Palliative Care Course: The Business Case for Palliative Care – 4 hour self paced online($229)