Improving Value of Care for Older Adults With Advanced Medical Illness and Functional Decline: Cost Analyses of a Home-Based Palliative Care Program

Journal of Pain and Symptom Management
Christina Y ChenGregory J Hanson

Abstract

Identifying high-value health care delivery for patients with clinically complex and high-cost conditions is important for future reimbursement models. The objective of this study was to assess the Medicare reimbursement savings of an established palliative care homebound program. This is a retrospective cohort study involving 50 participants enrolled in a palliative care homebound program and 95 propensity-matched control patients at Mayo Clinic in Rochester, Minnesota, between September 1, 2012, and March 31, 2013. Total Medicare reimbursement was compared in the year before enrollment with the year after enrollment for participants and controls. No significant differences were observed in demographic characteristics or prognostic indices between the two groups. Total Medicare reimbursement per program participant the year before program enrollment was $16,429 compared with $14,427 per control patient, resulting in $2004 higher charges per program patient. In 12 months after program enrollment, mean annual payment was $5783 per patient among participants and $22,031 per patient among the matched controls. In the second year, the intervention group had a decrease of $10,646 per patient; the control group had an increase of $76...Continue Reading

References

Apr 12, 2002·Journal of the American Geriatrics Society·Joan M TenoNeal V Dawson
Mar 27, 2003·Journal of the American Geriatrics Society·Kenneth E CovinskyKristine Yaffe
Nov 19, 2003·Journal of Palliative Medicine·Richard D BrumleyDavid A Cherin
Oct 16, 2004·Journal of General Internal Medicine·Elise C CareyKenneth E Covinsky
Feb 16, 2006·JAMA : the Journal of the American Medical Association·Sei J LeeKenneth E Covinsky
Jul 5, 2007·Journal of the American Geriatrics Society·Richard BrumleyJorge Gonzalez
Mar 11, 2009·Archives of Internal Medicine·Baohui ZhangHolly G Prigerson
Dec 15, 2010·The New England Journal of Medicine·Michael E Porter
Jun 12, 2013·Journal of Palliative Medicine·Katherine OrnsteinTheresa Soriano
Oct 16, 2015·American Journal of Public Health·Melissa D Aldridge, Amy S Kelley
Mar 19, 2016·Health Services Research·Amy S KelleyChristine S Ritchie
Mar 24, 2016·Healthcare : the Journal of Delivery Science and Innovation·Paul Y TakahashiGregory J Hanson
Aug 31, 2016·Journal of Palliative Medicine·Dana LustbaderDavid Cooper
Sep 4, 2016·Journal of the American Geriatrics Society·J Brian CasselDaniel Hoefer
Jul 7, 2017·Health Affairs·Diane E MeierR Sean Morrison

❮ Previous
Next ❯

Citations

May 15, 2020·Holistic Nursing Practice·Zohreh GhezelsefliEesa Mohammadi
Aug 2, 2020·Mayo Clinic Proceedings·Paul Y TakahashiGregory J Hanson
Sep 19, 2020·Journal of Pain and Symptom Management·Brystana G KaufmanDonald H Taylor
Oct 13, 2021·Journal of Palliative Medicine·Marvin J GordonAijing Gao

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.