Palliative Care Providers Hitting Walls in Value-Based Reimbursement

Posted Saturday, April 2, 2022

CMS has decided to dip its toes into value-based reimbursement for palliative care. Interest in these programs is growing among providers, but many find barriers that block their access or limit their ability to scale.

Some Accountable Care Organizations (ACOs) and Medicaid managed care plans also address palliative care.

These expansions of payment options are positive steps, but gaps exist in their design.

“We certainly need a lot more than what’s currently available. There’s a lot of patients and families out there with serious illnesses who would benefit from home-based palliative care or clinic-based palliative care,” J. Brian Cassel, palliative care research director for the Virginia Commonwealth School of Medicine, told Hospice News. “That’s a robust, multidisciplinary form of palliative care that will be distinct from hospice. We’re overdue for payers and providers to work together to come to an agreement on how to make that happen.”

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