Palliative Care for VNS Health Medicare Patients
VNS Health Medicare offers specialized palliative care for patients living with a serious illness. The goal is to improve quality of life for patients and their families through strategies to prevent rapid decline, including early identification of the need for palliative care and relief of suffering through the treatment of pain and other challenges, whether physical, psychosocial, or spiritual.
The patient’s primary care physician (PCP) remains in charge of the patient’s overall care, writes orders, and sees the patient for office visits during the course of palliative care. A Palliative Care team works in partnership with the PCP and the patient’s other doctors, to communicate and align on treatment goals and provide support to the patient and their family and/or caregiver.
If you have a VNS Health Medicare patient who you think would benefit from palliative care, please email the required information (see directly below) to [email protected].
Information required for referral:
- Patient’s name and date of birth
- Patient’s health plan member ID number (if available)
- Patient’s address and phone number
- Patient’s diagnosis
- Referring physician’s name and phone number
Palliative Care Frequently Asked Questions
Palliative care is appropriate at any age and any stage in a serious illness and is based on the needs of the patient, not the prognosis. Unlike the Medicare hospice benefit, palliative care does not have a prognosis restriction and may be provided alongside curative treatment.
We use proprietary predictive algorithms to identify patients in greatest need of palliative care services. The following criteria are considered:
- Multiple co-morbidities
- Need for pain and/or symptom management related to a chronic or life-limiting condition
- Psychosocial and/or spiritual distress of both member and caregivers related to the patient’s condition
- Need for Advance Care Planning (including Advance Directives) and clarification of health care goals for member and caregivers
- Members with end stage illness who have refused the Hospice benefit despite eligibility
- Multiple hospital admissions or ER visits over the past year
A specially trained team, led by a nurse practitioner and consisting of doctors, nurses, and other health professionals, work together with the patient’s regular doctors to provide an extra layer of support, at no additional cost.
- Multidisciplinary team providing in-home support (nurse practitioner, registered nurse, social worker, spiritual counselor, health and wellness coaches, and transitional care associates)
- Management of relief of symptoms, pain, and stress
- 24/7 access and interdisciplinary team support
- Emotional and spiritual support
- Collaboration with patient’s treatment team (e.g., PCP, specialists)
- Linkages to community-based organizations/resources
- Curative treatment included for chronic illnesses
Your patient will be assessed for palliative care eligibility. If he/she meets criteria for the program, you will be notified. As the primary care physician, you are expected to remain in charge of the patient’s care, write orders, and see the patient for office visits while the patient in enrolled in a palliative care program.
Resources
- Palliative Care Brochure (for members)
- Comfort Care Options Flyer (for providers)
- CAPC – What is Palliative Care
- NHPCO- Facts-Figures 2021 (Available in PowerPoint or pdf)