West Virginia Medicaid currently does not reimburse for interdisciplinary palliative care, other than hospice care, but doing so could reduce costs or at least be cost-neutral while improving quality of care. The Medicaid program should consider adding palliative care as a reimbursed benefit. Legislation might need to be considered to provide for that change.
Benefits of palliative care
- Palliative care is part of the same spectrum as hospice of specialized, interdisciplinary medical care for people living with serious illnesses, such as cancer, heart failure and kidney failure. Hospice is the highest level of support in palliative care services.
- Palliative care involves comprehensive treatment of patients’ discomfort, symptoms and the stresses of serious illness with a goal of relieving pain and improving quality of life.
- The difference between palliative care and hospice care is that hospice care is for patients with terminal prognoses, while palliative care can be provided along with curative care.
- Palliative care services and hospice services have been differentiated based on what Medicare (as designed in the 1980s) is willing to pay for end-of-life care, limiting hospice benefits to six months or less. However, palliative care is needed earlier than that.
- Some private insurance plans and certain state Medicaid programs have added palliative care as a covered benefit or are headed in that direction.
Financial advantages of palliative care
- Studies show that palliative care can save costs by providing more care outside of hospitals in less-expensive settings, such as patients’ homes, although palliative care is not limited to home delivery.
- The dual goals of reimbursing for palliative care should be cost savings and improved quality of care.
For a more detailed paper, see HCWV Palliative Care Paper