The Growing Demand for Holistic Home-Based Care

As the population ages and chronic illnesses become more prevalent, the demand for comprehensive, patient-centered care delivered in the home is surging. Palliative care, focused on providing relief from the symptoms and stress of serious illness, is increasingly recognized as a crucial component of this evolving care paradigm. While often associated with end-of-life care, palliative care can – and should – be offered alongside curative treatments, improving quality of life for patients and their families.

Benefits Beyond Symptom Management

Dr. Kurt Merkelz, chief medical officer at Compassus, emphasizes the synergistic relationship between home health and palliative care. “By leveraging palliative care partnerships with your home health, first achieving outcomes in symptom management, we do well in getting patient symptoms controlled,” he explained. “It increases patient satisfaction. We provide tremendous amounts of education to caregivers. This, in turn, results in improved home health CAHPS scores.” Compassus, with over 270 locations across 30 states, offers a full spectrum of home-based services, including home health, palliative care, and hospice care.

The advantages extend beyond improved patient experience. Nikki Davis, senior vice president of palliative care programs at Contessa Health (acquired by Amedisys Inc. in 2021), highlights the value of bi-directional referrals. “Obviously, there are rules, regulations and compliance around sharing information about patients,” Davis noted. “How do you go about that in a compliant and regulatory fashion? It’s not easy and it’s slow, but once you get there, it’s well worth it.” Contessa partners with 12 health systems and 30 health plans to deliver comprehensive in-home care.

For providers serving rural communities, palliative care can be a particularly valuable differentiator. Merkelz points out that patients in these areas often face significant barriers to accessing specialist care. “Home health patients who are mobility impaired, who live in rural locations… they have significant difficulties in reaching their primary care and specialist providers,” he said. “Palliative care can help bridge that interaction, and be another supportive layer of seeing the patient, coordinating and communicating with the specialists and the primary care doctor, and what’s taking place in real-time in the home.”

The complexity of chronic disease management further underscores the need for palliative care integration. Merkelz explains, “The home health patient is not just a hip repair that needs rehabilitation. They’re faced with their diabetes, their COPD, their heart disease, their hypertension, along with cognitive impairment. You can’t parcel out single components of their care. Chronic care management is complex. It requires coordinated efforts. Palliative care can be an incredible support in relaying information, guiding the right medications and acute care visits.” Dorothy Davis, president and CEO of Visiting Nurse Health System, echoes this sentiment, emphasizing the importance of understanding a patient’s trajectory and managing chronic disease in a successful palliative program. Visiting Nurse Health System, based in Atlanta, has been providing palliative care for over 15 years, serving more than 7,000 patients.

But what are the biggest hurdles preventing more widespread adoption? What role does technology play in facilitating better care coordination?

The Path Forward: Reform and Innovation

Despite the clear benefits, significant changes are needed to facilitate broader adoption of palliative care within the home health sector. Reimbursement reform is paramount, according to Merkelz. Current payment models often fail to adequately compensate providers for the comprehensive, interdisciplinary services that define effective palliative care. Regulatory adjustments and enhancements to electronic medical records (EMRs) are also crucial.

“We need standards on what services are going to be provided,” Merkelz stated. “What are the outcomes that need to be measured? We need reform under education and how we’re providing education to every stakeholder. We need EMR enhancements… We need improved documentation of what’s taking place, of goals of care, advanced care planning. We need to be able to target and track our symptom management.”

Ultimately, diversifying into palliative care offers at-home care providers a unique opportunity to differentiate themselves, improve patient outcomes, and enhance the overall quality of care. However, realizing this potential requires a concerted effort to address the systemic challenges that currently impede its widespread adoption.

Frequently Asked Questions About Palliative Care