(McKnight) June 5, 2017
by Diane Meier,M.D.
Nursing homes are under mounting pressure to improve quality of care. The Centers for Medicare & Medicaid Services last year introduced new quality measures that hold nursing homes accountable for preventing or reducing hospital readmissions or emergency department visits for short-stay residents. This year, CMS is designing a value-based purchasing program for skilled nursing facilities, which will adjust reimbursement rates based on the quality of care they deliver. The program is scheduled for launch in 2019. As nursing homes work to adapt to the new payment and quality landscape, one compelling solution is to integrate palliative care, a form of person-centered interdisciplinary care focused on quality of life for the seriously ill.
Palliative care is specialized medical care for people living with serious illness. It provides relief from symptoms and distress, addresses resident and family needs for communication and coordination and offers guidance in making treatment decisions that are aligned with the life priorities of residents.
In multiple studies – including some conducted in nursing homes – palliative care has been shown to reduce pain and other symptoms, reduce depression and anxiety and avert symptom crises and their associated emergency department and hospital stays. It may even prolong life by protecting patients from the many risks of hospitalization. These elements all contribute to improvements in quality and reductions in acute care utilization.
Palliative care produces high quality clinical and efficiency outcomes for residents, their families, nursing home staff and the health system. Nursing homes that integrate palliative care can build a track record of high quality care and low rates of readmission and emergency department use that will position them for success as reliable partners to the clinicians and the hospitals in the community. In the new value-based payment environment, these are the nursing homes that risk-bearing organizations (just about everybody, these days) will seek out for collaboration, partnerships or contracts as they seek to deliver value across the continuum of care.
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