The American Academy of Hospice and Palliative Medicine (AAHPM) proposed an alternative payment model (APM) that includes monthly payments for care teams, including nurses, social workers and spiritual care professionals.
The Patient and Caregiver Support for Serious Illness (PACSSI) model was developed to address the gaps in care given to seriously ill patients. The proposal states that new payment processed should be based on a patient’s need and the severity of their disease in order to support palliative care services.
Two Track Model
Track One: Up to 4 percent of annual total care management fees – includes positive and negative payment incentives
Track Two: Shared risk and savings, based on total care costs subject to adjustments from quality measures.
Pay palliative care teams
$400 per month
Monthly payments would replace evaluation and management service fees, such as those for office, home and hospital visits; chronic care, complex chronic care and transitional care-management services; and advance care planning services.
Replacing these service fees with monthly care-management payments would reduce a marginal incentive to provide unnecessary visits, according to the proposal.
A letter to PTAC Chair from James L. Madara, MD, executive VP and CEO of the American Medical Association (AMA), expressed strong support for the AAHPM proposal. The letter was quoted by AMA Wire,
The AMA supports further testing and adoption of the PACSSI care model proposal, and believes this model shows promise in promoting care coordination and delivering palliative care and support services which better align with patient preferences. The AMA believes the PACSSI model will improve the quality of care for Medicare beneficiaries with serious illness, while reducing costs for the Medicare program.
The abstract of AAHPM’s proposal states:
Patients who have serious, potentially life-limiting illnesses or multiple chronic conditions coupled with functional limitations are not well-served by the current fragmented, intervention-oriented health care system.
AAHPM claims to want to address barriers that prevent patients and caregivers from receiving palliative care and support services by allowing the delivery of these services to homes of high-need patients that are not willing or eligible for hospice care.
This model would allow the Medicare program (and other payers as interested) to test a new approach to providing palliative care services that addresses patients’ needs and preferences early, in order to provide better care and control unnecessary and unwanted health care spending.
To read the full proposal, click here.
To read the AMA Wire article, click here.