Designing and Implementing Home-Based Palliative Care: A Guide for Payers

Mollie Gurian
Amy Abdnor
Anna Kyotenen
Torrie Fields
Implementation Tool
January 2019


A practical guide for payers interested in creating home-based palliative care programs with lessons and case examples from a California health plan.


In 2017, Blue Shield of California (BSC) piloted a value-based home-based palliative care program in partnership with Hill Physicians Medical Group and Snowline Hospice. Within the first year, BSC achieved their goals of improving use of serious illness management services and benefits, meeting quality metrics, and patient satisfaction. This toolkit guides payers through the process of designing and implementing a home-based palliative care program and outlines practical lessons from the BSC pilot.

About this Tool

This tool highlights the key decisions, questions, and considerations for developing a home-based palliative care program from the perspective of the payer. Throughout the resource, examples of BSC’s pilot provide practical lessons for implementation. The guide focuses on six stages of the design and implementation process:

  • Defining Program Goals

  • Building the Business Case

  • Designing Your Program

  • Payment and Finance

  • Network Build and Management

  • Program Operationalization

Toolkit appendices offer resources to define quality measurement, sample job descriptions for the palliative care leadership team, evidence-based literature to build the business case, and a workforce assessment that can be used by accountable care organizations.


This toolkit can be a resource for payers designing or implementing a home-based palliative program. The lessons from the BSC value-based arrangement pilot can serve as a helpful guide when navigating the different phases of program implementation.

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