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Tracking Patients in Community-Based Palliative Care through the Centers for Medicare & Medicaid Services Healthcare Innovation Project.

Publication ,  Journal Article
Bull, J; Kamal, AH; Harker, M; Bonsignore, L; Morris, J; Massie, L; Singh Bhullar, P; Hendrix, M; Bennett, D; Taylor, D
Published in: J Palliat Med
November 2017

BACKGROUND: Although limited, the evidence base for Community-Based Palliative Care (CBPC) has shown that it improves patient health outcomes, increases satisfaction, and decreases cost. Minimal data exist comparing points of entry into palliative care and patient transition outcomes. OBJECTIVES: In 2014, Four Seasons Compassion for Life was awarded a Centers for Medicare & Medicaid Services Healthcare Innovation Award to expand an existing CBPC model into additional counties and to propose a new payment approach. The goal of this article is to evaluate the tracking of point of entry into palliative care and patient transition outcomes in the model. DESIGN: All participant transition outcomes are tracked from point of entry, including large and small hospitals, nursing facilities, and home/clinic. Evaluation of tracking data was conducted over the first two years of the project (September 1, 2014-September 1, 2016). RESULTS: A total of 2482 patients entered the project, 905 through smaller hospitals (<300 beds, 32%), 474 through larger hospital systems (>500 beds, 17%), 823 from nursing facilities (29%), and 640 in the home/clinic (22%). Hospice transition was highest with home/clinic referrals, followed by nursing facilities, smaller hospitals, and larger hospitals. Palliative care deaths and discharges are higher in larger hospitals. Re-enrollment back into palliative care after previous discharge occurred in 177 (17.8%) of discharged patients. CONCLUSION: CBPC leads to the highest percentage of hospice transitions coming from the home/clinic setting. Differences between small and large hospitals demonstrate a different patient population with higher transitions to hospice and lower palliative care deaths in smaller hospitals.

Duke Scholars

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Published In

J Palliat Med

DOI

EISSN

1557-7740

Publication Date

November 2017

Volume

20

Issue

11

Start / End Page

1231 / 1236

Location

United States

Related Subject Headings

  • United States
  • Patient Transfer
  • Patient Discharge
  • Palliative Care
  • Medicare
  • Male
  • Humans
  • Hospitalization
  • Hospice Care
  • Gerontology
 

Citation

APA
Chicago
ICMJE
MLA
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Bull, J., Kamal, A. H., Harker, M., Bonsignore, L., Morris, J., Massie, L., … Taylor, D. (2017). Tracking Patients in Community-Based Palliative Care through the Centers for Medicare & Medicaid Services Healthcare Innovation Project. J Palliat Med, 20(11), 1231–1236. https://doi.org/10.1089/jpm.2017.0080
Bull, Janet, Arif H. Kamal, Matthew Harker, Lindsay Bonsignore, John Morris, Lisa Massie, Parampal Singh Bhullar, Mark Hendrix, Deeana Bennett, and Don Taylor. “Tracking Patients in Community-Based Palliative Care through the Centers for Medicare & Medicaid Services Healthcare Innovation Project.J Palliat Med 20, no. 11 (November 2017): 1231–36. https://doi.org/10.1089/jpm.2017.0080.
Bull J, Kamal AH, Harker M, Bonsignore L, Morris J, Massie L, et al. Tracking Patients in Community-Based Palliative Care through the Centers for Medicare & Medicaid Services Healthcare Innovation Project. J Palliat Med. 2017 Nov;20(11):1231–6.
Bull, Janet, et al. “Tracking Patients in Community-Based Palliative Care through the Centers for Medicare & Medicaid Services Healthcare Innovation Project.J Palliat Med, vol. 20, no. 11, Nov. 2017, pp. 1231–36. Pubmed, doi:10.1089/jpm.2017.0080.
Bull J, Kamal AH, Harker M, Bonsignore L, Morris J, Massie L, Singh Bhullar P, Hendrix M, Bennett D, Taylor D. Tracking Patients in Community-Based Palliative Care through the Centers for Medicare & Medicaid Services Healthcare Innovation Project. J Palliat Med. 2017 Nov;20(11):1231–1236.
Journal cover image

Published In

J Palliat Med

DOI

EISSN

1557-7740

Publication Date

November 2017

Volume

20

Issue

11

Start / End Page

1231 / 1236

Location

United States

Related Subject Headings

  • United States
  • Patient Transfer
  • Patient Discharge
  • Palliative Care
  • Medicare
  • Male
  • Humans
  • Hospitalization
  • Hospice Care
  • Gerontology