Advanced Illness Care Progress Opportunities Jennifer Malin MD
- Slides: 6
Advanced Illness Care Progress & Opportunities Jennifer Malin, MD, Ph. D Staff Vice President, Clinical Strategy Assessing Progress in End-of-Life and Serious Illness Care National Academy of Medicine May 23, 2016 COMPANY CONFIDENTIAL | FOR INTERNAL USE ONLY | DO NOT COPY
60% of Anthem members with cancer have a hospital admission in month prior to death 30% have an ICU admission in month prior to death Early access to palliative care is critical to improve quality of care Goals of Palliative Care – are to anticipate, prevent and reduce suffering and to support the best possible quality of life for the patient and family, regardless of the stage of disease or the need for otherapies. ANTHEM INC. CONFIDENTIAL | DO NOT COPY | DO NOT DISTRIBUTE 2
3 month improvement in survival Same or better quality of life And, $4, 000 to $7, 000 lower cost for patients who receive palliative care Smith et al. Palliative Medicine 2014, 28: 130 -50 Hughes and Smith. Annu Rev Public Health. 2014; 35: 459 -75 Temel et al. N Engl J Med 2010; 363: 733 -42; Bakitas et al. J Clin Oncol 2015; 33: 1438 -45. Gade et al. J Palliative Medicine 2008; 11: 180 -90; Grudzen et al. AAHPM Abstracts 2015; Higginson Lancet Respir Med 2014; 2: 979– 87 ANTHEM INC. CONFIDENTIAL | DO NOT COPY | DO NOT DISTRIBUTE 3
66% of U. S. hospitals with more than 50 beds have a palliative care team • Access to palliative care outside of inpatient setting or hospice remains extremely limited • Current workforce 6600 board certified palliative care physicians is only 1: 20, 000 persons with chronic illness • Estimated shortage of 18, 000 palliative care physicians • 15% of spots in palliative care fellowship unfilled ANTHEM INC. CONFIDENTIAL | DO NOT COPY | DO NOT DISTRIBUTE 4
Need integrated advanced illness care in addition to specialty palliative care Primary palliative care provided by physician assuming primary responsibility for caring for patients – e. g. PCP, oncologist, cardiologist – with support as needed from palliative care specialist Primary Care Specialist disease care (e. g. oncology, cardiology) + Integrated Primary Palliative Care HOSPICE Specialty Palliative Care Quill TE and Abernethy AP. N Engl J Med. 2013 Mar 28; 368: 1173 -5
Anthem efforts to improve access to advanced illness care § Expansion of hospice benefit § Added look-up for physicians board certified in hospice and palliative care medicine on Anthem website “Find a Doctor” § Palliative care needs assessment implemented in case management programs § Pilots with vendors that provide palliative care solutions § Developing integrated advanced illness care program to support network physicians in providing primary palliative care
