The Intersection of Compassion and Quality in Healthcare’s Most Challenging Moments

We’ve discussed advanced illness management previously in this space, focusing on the challenges faced by Medicare and healthcare plans and providers in examining both the cumulative costs of care provided to patients in the final months of life while wanting to do what is in the best interest of those patients and their loved ones.

Two Healthcare Leadership Council members provided insights on this issue in a Senate Special Committee on Aging hearing that took place last week.  Executives from Ascension Health, the nation’s largest non-profit hospital system, and Aetna, one of the country’s leading health insurers, shed important light on advances that are taking place to reduce the cost of advanced illness management while generating greater satisfaction among patients and families.

Dan O’Brien, Ascension Health’s Senior Vice President of Ethics, Discernment and Church Relations, discussed Ascension’s system-wide Palliative Care initiative, which has enabled the creation of standardized measures and outcomes as well as demonstrated financial feasibility and sustainability.  Within one year, he said, a 20 percent compliance rate within the Ascension system has grown to an 80 percent compliance rate with the palliative care program.  Palliative care teams have increased the quality of care while reducing costs, reducing length of stay, and increasing patient and family satisfaction.  He noted, however, that palliative care teams still struggle to receive necessary funding and he asked the committee to support appropriate funding for palliative care and advanced care planning.

Dr. Randall Krakauer, the National Medical Director of Medicare for Aetna, told the committee that, in the last month of life among seniors, 80 percent of care is received in an acute care setting, even when it’s not medically appropriate.  Palliative and hospice care, he said, reduces the use of medically unnecessary services and positively impacts beneficiary satisfaction and quality of care.  Aetna launched its Compassionate Care Program to assist plan members in managing their illnesses and has had strong results with the Medicare population, seeing a more than 80 percent reduction in acute days, intensive care days and emergency room use.  Dr. Krakauer testified it would be a positive step for Medicare Advantage beneficiaries to have access to hospice earlier and be able to receive curative treatment while in hospice.

With their testimony, these two organizations made significant contributions to the ongoing conversation and body of knowledge on how to address advanced illness care, making important points about the role of Medicare coverage regulations and funding for palliative care.