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A joint study by the Center to Advance Palliative Care and the National Palliative Care Research Center (America’s Care of Serious Illness: 2019 State-by-State Report Card on Access to Palliative Care in Our Nation’s Hospitals) offers an instructive snapshot of where we are today. Of the 89 palliative care programs offered at 138 Florida hospitals in the study, fully one-half were the sole provider of palliative care for its community, which earned the state an overall grade of “B” in the report.
Additional studies demonstrate that palliative care reduces avoidable spending and unneeded services across settings in the following ways:
• Reduces inpatient readmissions by 48% and costs by 28% per day
• Reduces hospital admissions by half and emergency room visits by more than one-third
• Reduces the need for patients to be transferred from skilled nursing facilities to the hospital or emergency room by 43%
• Reduces total costs of home-based care by 36%.
On the state level, more can be done to improve costs. Florida Tax Watch, which has been a nonpartisan watchdog for four decades, noted in a March 2019 report, “To ensure the financial stability of palliative care providers, a system of care reimbursement that can be used by public and private payors must be developed, along with a definition of the services that constitute palliative care.”
What more proof do we need that palliative care isn’t just for the last six months of life than the fact that approximately nine in 10 of the nation’s sickest patients (the five percent who account for half of all health care costs) are expected to live for more than a year?
The rate of serious illness and functional dependency driving these numbers will only increase as the population ages. It is time to support evidence-driven best practices in order to increase access and manage costs.
Last year, the Centers for Medicare and Medicaid Services contracted with the American Academy of Hospice and Palliative Medicine to develop new palliative care quality metrics. Locally, Palm Beach Hospice and Palliative Care by MorseLife is the only teaching program in the state. We will be sharing data to drive best-practices in the field.
The Census Bureau offers the sobering projection that as early as next year there will be fewer than four people of working age (20 to 64) to every person 65 and older. This has far-reaching implications for the funding of Medicare and Medicaid, as well as for the need to develop a caregiver and provider workforce.
Congress should pass the Palliative Care and Hospice Education and Training Act which would promote grants to medical schools and teaching hospitals and provide workforce development and career incentive awards.
The State’s aforementioned grade of “B” is not a bad grade unless you or someone you love is struggling with a serious illness – as is the case for at least 12 million adults and 400,000 children across the country. Palliative care should be readily available in South Florida.
