3 Reasons Why Palliative Care Belongs in the Community

A recent study published in the Journal of Social Science and Medicine points to the effectiveness of community-based palliative care (CBPC) in increasing care quality and reducing costs. The study also underscores the need for additional research on CBPC programs to continue to increase care quality and access for the most vulnerable populations.

As a key part of our national policy agenda, we advocate for increased access to community-based support and services. This involves engaging in innovative approaches to reforming the two largest payers in the U.S. healthcare system, Medicare and Medicaid, to enhance coverage for health-related social supports, such as those associated with palliative care. In today’s value-based healthcare environment, providers are increasingly recognizing the importance of keeping people living with serious illnesses connected to their communities while receiving palliative care. Community-based palliative care does this by providing patients with services that improve their quality of life in their own community and prevent unnecessary hospital visits.

For the first time, a systematic review of literature demonstrating CBPC’s effectiveness has been performed, and it affirms the benefits of integrating health systems with community-level services to provide palliative care. Using the findings of this study as evidence, we’ve identified three key reasons to why palliative care belongs in the community:

1. Research shows that CBPC is effective at reducing healthcare costs. According to the CDC, over 90% of our nation’s healthcare costs can be attributed to treating chronic diseases. Additionally, end-of-life care is a major source of spending for Medicare beneficiaries, and recent analyses have demonstrated the need for programs that better manage the care of people with serious illnesses to reduce costs. Several U.S. studies demonstrate cost reduction for patients utilizing CBPC programs. As the U.S. population continues to age at a disproportionate rate, with people age 65 or older expected to outnumber children in the U.S. by 2030, CBPC offers a cost-effective solution to meeting healthcare needs.
2. CBPC is associated with favorable patient-centered outcomes, indicating increased care quality. At C-TAC we focus on the patient and their families, so it is noteworthy that research shows CBPC is effective at improving patient-centered outcomes, such as dying in place of preference and overall satisfaction with palliative care. When people receive care that they need and want from their own community they can experience increased care coordination and less hospital readmission, topics covered by National Quality Forum quality metrics.
3. CBPC can help rectify health inequities by equipping and empowering communities to provide quality care that aligns with their needs and values. If properly resourced, communities can care for their most vulnerable members effectively. There are various examples of palliative care models that incorporate health equity principles, and it is included in our Core Principles for Care Models.

Beyond building on the case for CBPC, the recent study points to the need for increased research on CBPC programs in order to enhance their effectiveness and properly allocate resources to those that work best. The researchers recommend grouping additional research on CBPC programs by disease and other patient characteristics. Further, with increased insight into the effectiveness of CBPC, the researchers recommend collaborative development of best practices by governments, health systems, and researchers to inform new care models.

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