Improving Care and Outcomes for Patients with Advanced Illnesses and their Caregivers- Policy and Practice Implications Bill Novelli Professor, McDonough School of Business, Georgetown University Co-Chair, Coalition to Transform Advanced Care (C-TAC) Co-Chair, Care Culture and Decision-Making Innovation Collaborative (National Academy of Medicine) November 1, 2018 #PCORI2018
Bill Novelli, Co-Chair, Coalition to Transform Advanced Care • Disclosure: C-TAC has received three funding awards from PCORI 2 • November 27, 2018
The Big P icture • We are making progress on the policy and practice front • Much is happening on both the federal and state level • We need more/better evidence to expand access to palliative/advanced illness care 3 • November 27, 2018
The Coalition to T ransform A dvanced Care (C-TAC) C-TAC's Goal: All Americans with advanced illness receive comprehensive, high-quality, person-centered care that is consistent with their goals and values, and honors their dignity. • Policy and Advocacy • Family care-giver support • State and Community Coalitions • Advanced Care Transformation Index • Respecting Choices • National Summit on Advanced Illness Care 4 • November 27, 2018
Federal Policy Progress • Passed legislation • CHRONIC Care Act (Balanced Budget Act) to extend Independence at Home demonstration, allow Medicare Advantage supplemental benefits, expand use of telehealth • RAISE Family caregiver Act to develop national family caregiver strategy • Finalized regulation • Allow Medicare Advantage supplemental benefits such as home-based palliative care, transportation, and nutrition services • Exclude palliative care population from Part D Opioid Overutilization program • Alternate payment models • C-TAC and AAHPM models approved by PTAC for “urgent testing” • HHS Sec. Azar confirmed they are a priority • CMMI to soon announce own home-based palliative care demonstration 5 • November 27, 2018
Health Plan/Payer Activity • Multi-payer group : CAPC and C-TAC recently sponsored meeting of 20+ health plans offering, piloting or considering palliative care services/benefits • California : Blue Shield now offers home-based palliative care as standard benefit and managed Medicaid plans have to also offer due to recent legislation • Pilots in other states with other payers 6 • November 27, 2018
State Coalitions • California Coalition for Compassionate Care - Recent legislation to require managed-Medicaid to offer palliative care • Massachusetts Coalition for Serious Illness Care - Surveyed state on advanced directives attitudes, leveraging Gawande’s Serious Illness Conversation tools • Oregon - Cambia funding needs assessment and developing messaging to promote serious illness care • Other state coalitions in various stages of development 7 • November 27, 2018
PCORI Research • Investing in studies on advance care planning, including one using C-TAC’s Respecting Choices First Steps materials • Other studies will test advanced illness and/or palliative care models to see which are most effective • Need more/strong evidence to persuade health system, policy, payer stakeholders to offer these programs/benefits 8 • November 27, 2018
The Blue Chair and Driving Miss Norma 9 • November 27, 2018
Learn More • www.pcori.org • info@pcori.org • #PCORI2018 • C-TAC Homepage: www.thectac.org • National Summit Page: www.ctacsummit.org 10 • November 27, 2018
Thank You! Bill Novelli Professor, McDonough School of Business, Georgetown University Co-Chair, Coalition to Transform Advanced Care (C-TAC) Co-Chair, Care Culture and Decision-Making Innovation Collaborative (National Academy of Medicine) November 1, 2018 11 • November 27, 2018
Advanced Medical Care: Improving Veterinary Anesthesia AAHA National Staff
Improving Care & Outcomes Presentation to Macquarie Private Wealth Clients
Integrated Locality Care Teams Improving outcomes for individuals through
Role of Technology in Improving Care for Complex Patients Sue Vos, RN Program
Better Care and Outcomes for Dialysis Patients: Dissemination of PCORI
NAM WORKSHOP SERIES ON HIGH-NEED PATIENTS Matching patients to tailored care
Improving Care and Outcomes of High Risk Newborns after NICU Discharge using
Systems for patient-centered care Protocols & systems to deliver high
Engaging Patients, Stakeholders, and Community as Partners in Patient-
NAM WORKSHOP SERIES ON HIGH-NEED PATIENTS Matching patients to tailored care
Dawn Dompierre, MOST Project RN Sandy Lundmark, Community Practice &
Secretary of State Barbara K. Cegavske Presented by Gail Anderson, Deputy
Catholic End-of of-Life Moral-Medical Decisions Overview Moral Principles
CATHOLIC END-OF-LIFE MORAL MEDICAL:,0 DECISIONS Speakers: Fr. Charles
483.10(b)(4) and (8) Rights Regarding Advance Directives, Treatment, and
Building a Palliative Care Program From the Inside Out Patsy Astarita,
11/18/2015 ORIENTATION TO ADVANCE DIRECTIVES WITH INSTRUCTIONS FOR MENTAL
1 Multi-Stakeholder Perspectives on Implementation of an Advance Care
3-5+ Year Health Care Cost Control Roadmap Discussion Office of eHealth
Unusual and Difficult Situations Ann L Russell J.D.,M.S.W April 26, 2016
Georgia Department of Community Health Transition of Care Presentation to:
1/23/2020 Improving Care of the Seriously Ill: Evidence for Use of the