Care Transformation Center Blog

Four key considerations for developing an outpatient palliative care service

Bonnie Jin

Outpatient palliative care programs are cropping up around the country, yet only a few have the scale to manage growing expectations and successfully meet explosive demand.

To help systems navigate this booming frontier, we recently hosted a webconference led by one of the nation’s leading experts in palliative care, Dr. Michael Rabow, who talked about his experience with the IPAL Project: Improving Palliative Care.

If you couldn’t make it,  we’ve summarized four takeaways from the session that will be of interest to anyone either starting or growing their own program.

1. Conducting a needs assessment is the most important element of developing outpatient palliative care programs.

The single most common cause of problems for developing these programs is lack of foresight. Outpatient services are often built incrementally and reactively, hindering sustainable growth as demand rises. As patient expectations grow, they place overwhelming demands on limited resources. Planning ahead and securing funding before implementation will reduce this risk and provide clarity around core objectives as programs scale up.

2. Engage stakeholders early—they have the potential to make or break your program.

Stakeholders are defined as anyone who can help your program either succeed or fail (i.e. fellow colleagues, the health system at large, or potential competitors). Understand what their goals are for the program and what they’re willing to contribute to ensure that missions are aligned on all ends. Carefully aligned objectives are the cornerstone of a successful business case that preemptively defines the funding, functions, and boundaries of the program.

3. Be mindful of the benefits of outpatient palliative care programs beyond the financial ROI.

Palliative care services are simply not reimbursed enough to carry the costs of a program, and will operate at a loss unless there is additional revenue beyond CPT billing. Many organizations make the case for a program by combining clinical and other financial factors, including:

  • Recorded quality of life improvements for patients
  • Enhanced end-of-life planning with patients and families
  • Reductions in the total cost of a patient’s care

4. There is no singular staffing model for any particular program.

One of the most commonly asked questions we receive is how many staff members a program needs and what backgrounds should they have. There is a wide range of existing staff models across the country, and it’s difficult to say which models work better than others. From practices with only a few part-time physicians to entire teams composed of nurses, social workers, nurse practitioners—each program’s staffing model will depend on local needs. There is simply no right answer across the board.

Learn More

If you want to know more, Advisory Board members can log in to listen to a recording of the webconference

Don’t miss the next post. Subscribe to our blog to receive email alerts.