Patients who receive home-based palliative care (HBPC) services experience fewer emergency department visits, fewer hospitalizations and lower costs once they start receiving services.
That’s according to a recent study conducted by the West Health Research Institute of Blue Shield of California.
“Home-based palliative care is a powerful tool to improve the care of seriously ill members who struggle to have their health care needs met in the doctor’s office,” Jenelle Hallock, senior manager of growth and health solutions at Blue Shield of California, told Home Health Care News in an email. “The care is not only aimed at managing a member’s symptoms, but also provides emotional support and addresses social needs that can interfere with the ability of a member to access services. High-quality home-based palliative care shows promise in reducing hospital and emergency department utilization.”
Palliative care, generally, is specialized medical care focused on providing relief from the symptoms, pain and stress of a serious illness. Many home health agencies offer palliative care services, but they typically have been hard to manage financially. With the emergence of value-based care, that is beginning to change, however.
Amedisys Inc. (Nasdaq: AMED), AccentCare and Gentiva are just a few of the larger home health agencies offering palliative care in the home.
The objective of the study was to assess whether acute health care utilization and costs decreased after members were enrolled in the health plan’s HBPC program.
By using claims data for over 2,000 patients between 2017 and 2019, Hallock and her team were able to find that members enrolled in the HBPC program had fewer visits to the emergency department and fewer total hospitalizations during the study period compared to before the program started.
Additionally, the cost of care per member, per month was lower during the study period compared to before the program began — $2,746 after the study and $3,996 before.
Beyond hospitalization rates and total cost of care, the difference in mortality between the two groups came close to reaching statistical significance. There was a slight trend that indicated patients lived a longer life in the HBPC group, but the difference was not statistically significant, Hallock said.
The study’s authors did point out some limitations of the research. For instance, the study did not measure health care utilization and costs during the last six months of life — a period when costs typically rise. This limits the study’s ability to analyze potential cost savings associated with palliative care.
“There is a trend toward greater utilization and cost reduction for members in home-based palliative care, but further research is needed to fine tune the intervention and determine if this trend will become statistically significant,” Kim Bower, medical director at Blue Shield of California, said in an email. “There are also some indications from the study that home-based palliative care may extend a member’s life, but this also requires more research to understand the true impact.”
If palliative care were found to extend life, Bower added, it would reinforce that this type of care is “not only patient centered, but also truly improves quality.”
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