Strengthening the Payer-Provider Relationship for Value-Based Success in Home- and Community-Based Palliative Care

September 2021

Palliative care programs improve the quality of life of patients with serious illness by providing specialized care through symptom management, caregiver support, and care coordination. Home- and community-based palliative care programs offer the potential to better manage the quality and costs of services and also address patients’ preferences to be treated in the home. Misalignment between payers and providers, however, impedes the successful implementation and growth of these programs. Value-based payment arrangements in payer-provider partnerships offer an opportunity to support and expand access to home- and community-based services.

This Better Care Playbook webinar, made possible through the Seven Foundation Collaborative, explored how successful partnerships between providers and payers can support sustainable and effective home- and community-based palliative care programs. It featured perspectives from two providers, Hosparus Health and Presbyterian Health Services, and a payer, Helion, a division of Highmark Health. Torrie Fields, CEO of Votive Health, which facilitates value-based arrangements to support people with serious illness, discussed opportunities to improve payer-provider collaboration.


I. Welcome and Introduction

Speaker: Logan Kelly, MPH, Senior Program Officer, Center for Health Care Strategies (CHCS)

L. Kelly welcomed participants, introduce the speakers, and provided a brief overview of the Better Care Playbook and home-based palliative care.

II. Defining and Growing a Palliative Care Service Line

Speaker: Bethany Snider, MD, HMDC, FAAHPM, Chief Medical Officer, Hosparus Health

B. Snider discussedhow Hosparus Health, a hospice provider, launched community-based palliative care services and adapted their care model to meet patient needs. She shared insights on how providers can successfully enter and sustain value-based payment arrangements for community-based palliative care.

III. Integrating Palliative Care in Home and Community Care Models

Speaker: Nancy Guinn, MD, Medical Director of Clinical Transformation, Population Health, Presbyterian Healthcare Services

N. Guinn described Presbyterian Healthcare Services’ innovative home and community models of care that incorporate home-based primary care and palliative services across the care continuum. She discussed payment models that can support this care, including partnerships to serve high-need Medicare Advantage patients.

IV. Using Data to Drive Decisions and Improve Quality in Palliative Care

Speaker: Emily Jaffe, MD, Executive Medical Director, Helion

E. Jaffe shared Highmark’s data driven approach to identifying and managing complex patient populations. She also examined how Highmark uses value-based payment programs that incorporate home-based palliative care services to improve the quality and efficiency of care for patients with advanced or chronic illness.

V. Implications for Payers and Providers and the Path Forward

Reactor: Torrie Fields, MPH, Founder and CEO, Votive Health

T. Fields reflected on the presentations and discuss future trends and opportunities for payers and providers to collaborate on sustainable home- and community-based palliative care programs.

VI. Moderated Q&A 

Moderator: Logan Kelly, CHCS

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