Palliative Care

Palliative care bridges the gap between medically focused care with case management support, and hospice with focus on comfort only in the last 6 months of life. A multidisciplinary palliative team provides support, both medical and psycho-social, regardless of time to end of life. Patients do not forego any treatments or interrupt any current physician relationships when enrolling in palliative care. Programs may be in-patient, clinic based, home based, telehealth or a combination of venues. 24-hour availability is encouraged. Coordination with the existing medical team and the health plan is a key to success. Periodic rounding between the palliative providers and the health plan team facilitates making the managed care system seamless for members and providers. The most common adult diagnosis is cancer, but severe progressive disease of any organ system may be appropriate for referral. Some patients may stabilize or even improve. Pediatric palliative care is somewhat different with the diagnosis more likely being genetic, developmental, or neurologic. Severe diseases in children may be chronic and end of life discussions difficult. Communication skills facilitate advance care planning discussions whether advance directive or POLST. Palliative care is a cost-effective program that improves patient care without the patient relinquishing existing benefits.