Abstract
Pioneer ACOs in the USA have been addressing the challenge of reorganizing care delivery for the sickest and most complex Medicare beneficiaries for about 5 years. Because of their assumption of financial risk, these ACOs have focused resources and expertise on the most complex and costly patients in their population—those in need of palliative care. In this chapter, we combine reports from four Pioneer ACOs—Detroit Medical Center Michigan Pioneer ACO in partnership with the Hospice of Michigan; Partners Health System Pioneer ACO; UnityPoint Health Pioneer and MSSP ACO; and OSF Health Care Pioneer ACO. The authors review their strategies for integration of palliative care principles and practices including the motivations of leadership in supporting these programs, key challenges and misconceptions encountered, utilization and clinical quality metrics used to track impact, and settings staffing, and characteristics of care models employed.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Novelli WD, Halvorsen GC, Santa J. Recognizing an opinion: findings from the IOM Evidence Communication Innovation Collaborative. JAMA. 2012;308:1531–2.
O’Connor AM, Wennberg JE, Legare F, et al. Toward the “tipping point:” decision aids and informed patient choice. Health Aff (Millwood). 2007;26:716–25.
Milstein A, Shortell S. Innovations in care delivery to slow the growth of US health care spending. JAMA. 2012;308:1439–40.
Labson MC, Sacco MM, Weissman D, Gornet B, Stuart B. Innovative models of home-based palliative care. Cleveland Clin J Med. 2013;80(eSuppl 1):eS30–5.
Wagner EH, Austin BT, Davis C, et al. Improving chronic illness care: translating evidence into action. Health Aff. 2001;20:64–78.
Naylor MD, Brooten DA, Campbell RL, et al. Transitional care of older adults hospitalized with heart failure: a randomized controlled trial. J Am Geriatr Soc. 2004;52:675–84.
Coleman EA, Parry C, Chalmers S, Min SJ. The care transitions intervention: results of a randomized controlled trial. Arch Intern Med. 2006;166:1822–8.
Salpeter SR, Malter DS, Luo EJ, Lin AY, Stuart B. Systematic review of cancer presentations with a median survival of six months or less. J Palliat Med. 2012;15:175–85.
Salpeter SR, Luo EJ, Malter DS, Stuart B. Systematic review of non-cancer presentations with a median survival of 6 months or less. Am J Med. 2011;125(5):512.e1–6. Epub 2011 Oct 24.
Lamont EB, Christakis NA. Complexities in prognostication in advanced cancer: “to help them live the lives the way they want to”. JAMA. 2003;290:98–104.
Wynia MK, Von Kohorn I, Mitchell PH. Challenges at the intersection of team-based and patient-centered health care: insights from an IOM working group. JAMA. 2012;308:1327–8.
Crosson FJ. 21st-century health care: the case for integrated delivery systems. N Engl J Med. 2009;361:1324–5.
Calfo S, Smith J, Zezza M. Last year of life study. Centers for Medicare & Medicaid Services; 2008. Available at http://www.cms.gov/Research-Statistics-Data-and-Systems/Research/ActuarialStudies/Last_Year_of_Life.html. Accessed 26 Nov 2012.
Mulley AG, Trimble C, Elwyn G. Stop the silent misdiagnosis: patient preferences matter. BMJ. 2012;345:e6572.
Kaiser Family Foundation. Kaiser health tracking poll, March 2010. Key findings. p. 6–8. http://www.kff.org/kaiserpolls/upload/8285-F.pdf
Medicare Program; Amendment to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2011. Federal Register. 2011;76(6). 42 CFR Part 410.
Pear R. Obama returns to end-of-life plan that caused stir. New York Times; 25 Dec 2010. Accessed 2 Jan 2013. http://www.nytimes.com/2010/12/26/us/politics/26death.html?pagewanted=all
Kaiser Family Foundation. Kaiser Health tracking poll. Key findings; Nov 2011.
National Journal and The Regence Foundation. Living well at the end of life poll; Feb 2011. http://syndication.nationaljournal.com/communications/NationalJournalRegenceToplines.pdf
Center to Advance Palliative Care Public Opinion Poll. Accessed 20 July 2013. http://www.capc.org/tools-for-palliative-care-programs/marketing/public-opinion-research/2011-public-opinion-research-on-palliative-care.pdf
The Urban Institute. Medicare, medicaid and the deficit debate. p. 6; April 2012. http://www.urban.org/UploadedPDF/412544-Medicare-Medicaid-and-the-Deficit-Debate.pdf
Manchester J. CBO’s long-term projections for medicare and medicaid spending in the United States. Congressional Budget Office; Nov 2012. http://www.cbo.gov/sites/default/files/cbofiles/attachments/11-30-2012-OECD_Presentation.pdf
Congressional Budget Office (CBO). The 2012 long-term budget outlook; June 2012. http://www.cbo.gov/sites/default/files/cbofiles/attachments/06-05-Long-Term_Budget_Outlook_2.pdf
42 USC. §1395x(ww)(3) and 42 CFR 410.16(a).
H.R. 3962 as passed by the House of Representatives, section 1223; 2009.
Blumenauer Introduces Bill to Modernize Medicare Advance-Care Planning. Accessed 25 July 2013. http://blumenauer.house.gov/index.php?option=com_content&view=article&id=2187
Senator Mark Warner. Senior navigation and planning act. http://thomas.loc.gov/cgi-bin/bdquery/D?d112:16:./temp/%7EbdNB38::
Sens. Warner and Isakson Introduce Bipartisan Care Planning Act of 2013. Access 2 Aug 2013. http://www.isakson.senate.gov/public/index.cfm/news-releases?ID=010950ec-7cbd-414f-87e5-19c309524b4b
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer Science+Business Media New York
About this chapter
Cite this chapter
Stuart, B., MacPherson, A.L. (2014). This Is Your Life: Achieving a Comprehensive, Person-Centered Model of Care at the Intersection of Policy, Politics, and Private Sector Innovation. In: Kelley, A., Meier, D. (eds) Meeting the Needs of Older Adults with Serious Illness. Aging Medicine. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-0407-5_4
Download citation
DOI: https://doi.org/10.1007/978-1-4939-0407-5_4
Published:
Publisher Name: Humana Press, New York, NY
Print ISBN: 978-1-4939-0406-8
Online ISBN: 978-1-4939-0407-5
eBook Packages: MedicineMedicine (R0)