Personalized Care Support

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Presentation transcript:

Personalized Care Support The Regence Palliative Care Program Lee Spears, Program Director

Our Definition of Palliative Care Services provided in the care of any life-limiting medical event, condition, or disease. © 2015 Regence

Personalized Care Support © 2015 Regence

Components of the Benefit Palliative Care Case Management Advance care planning End of life counseling Home health medical visits Home health social work visits Removal of homebound requirement for care Removal of prior authorization for case management Non-member caregiver support © 2015 Regence

2015 Select Outcomes 500 – 600 cases projected for PCCM; 1256 cases opened in 2015 Target of 80% member satisfaction score for PCCM; achieved 94% rating Reduction in re-admittance rate from 30% to 25% © 2015 Regence

Is It Working for Our Members? Palliative Care Case Manager Debbie reached out to Marlon, who needed help understanding his options, getting his care coordinated, and his health stabilized. They worked together for a year, through Marlon’s hospitalization and treatment for cancer and other health issues. “I think (cancer) was Marlon’s wakeup call,” says Debbie. Nearly 12 months later, Debbie is closing Marlon’s case, and she is happy to report that his cancer is in remission and he’s reached a personal goal – visiting family (which he could not have done when Debbie first reached out). “There is so much more to this job than I could have ever anticipated,” Debbie shares. “It’s forever changed my definition of ‘success’.” © 2015 Regence

Yes, Yes It Is Bill, who required extensive oxygen therapy, wanted to return home for his final days. While the hospital worked to bring his oxygen requirements to a level that could be maintained at home, Regence Palliative Care Case Management reached out to Bill and his wife, Lani, to offer information about palliative care and hospice. The case manager explained to Lani about advanced directives, skilled nursing facility (SNF) options, what equipment may be needed in their home, and just listened to her concerns, wishes, and hopes for her husband. The case manager worked with Bill’s discharge coordinator to honor his wishes. He stayed in a SNF for a few days, and then spent his last weeks in comfort and ease in his own home. © 2015 Regence

Going Forward Recent launch of perinatal/neonatal hospice support (Aug) Launch of pediatric palliative care case management (June) Other benefit expansion opportunities Service bundles Cultural competency in palliative medicine training for providers Walking our talk at home: employee outreach © 2015 Regence