An Old Story with a New Twist for Improving Care Quality and Member Satisfaction
Written by: Cyndi Seiwert, Chief Operating Officer
It no surprise that when people who are suffering from complex, chronic illnesses are transferred back and forth to the hospital and become financially burdened with exorbitant co-pays for doctor visits and expensive interventions that they may not even want, they also become frustrated with their health plan participation.
Thankfully, healthcare payers can open a new chapter in the quest for helping these individuals to improve their quality of life and avoid over-medicalization, especially seniors with advanced illness who are undoubtedly among the most vulnerable members of any plan.
The new solution for resolving these challenges and concurrently enhancing member satisfaction is called Palliative Illness Management™ — PIM™.
By introducing the palliative care component to Advanced Illness Management (AIM), a growing number of health plans are adopting PIM™ as a stand-alone solution or plugging it into current population health programs. It is a recipe for restoring the confidence of millions of members who had inevitably become disillusioned with their health plan.
Evidence now shows that bringing PIM™ to members earlier, rather than later, in the disease care trajectory, leads to better health outcomes and higher satisfaction with care for both patients and their family caregivers. It also reduces the cost burdens for everyone.
Member Satisfaction with Community-Based Palliative Care – and Value to Payers
Why is palliative care so effective? Because it gets to the heart of problems that have simply not been addressed by traditional means: ongoing symptom management, having sensitive conversations about quality of life at the end-of-life, setting goals of care that meet individual preferences, needs and wishes, spiritual guidance — and more.
Given the understanding that their symptoms and interventions will be better managed, members often choose a treatment that is less aggressive, leading to fewer side-effects and lower costs of care.
Simply stated: PIM™ is what’s been missing in the lives of members who are suffering with life-limiting illnesses.
The value of the PIM™ solution also extends to payers as they tap into the resources of palliative care professionals who are available and often under-utilized in their communities. This obviates the need for expensive build-outs of palliative care networks or provider recruitment while building local support, advancing member enrollment and strengthening plan retention initiatives.
It also facilitates rapid market entry for payers in a matter of weeks vs. six to nine months, bringing compassionate, affordable and higher quality care to members in a relatively short time period.