Improving Care and Outcomes for Patients with Advanced Illnesses and - - PowerPoint PPT Presentation

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

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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

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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
• f 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
• n 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

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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