Trauma-informed Palliative Care: Interdisciplinary Perspectives on Assessing and Treating Patients and Families with Trauma- and Stress-Related Symptoms (SA505)

Abstract

Objectives Describe at least four available billing codes covering palliative care services. Describe four or more payment arrangements that can be used by any palliative care team, along with their pros and cons. Describe at least three primary interests of payers in provider contracting for their seriously ill members. Despite political uncertainties, the drive towards payment reform continues unabated, and palliative care providers have strong opportunities for sustainable payment. This session will help attendees to understand the opportunities better, as well as destroy some prevailing myths about alternative payment. First, this session will review the scope of successful payment arrangements that now exist for palliative care programs, both under Medicare and with private payers. This payment arrangement review will cover both important fee-for-service changes and alternative payments, drawing on interviews and market research conducted under the CAPC Payment Accelerator. Next, the session turns to a frank discussion with a health plan on their goals as a payer and the practical considerations they face in negotiating provider payments. It also covers how a health plan can compensate a palliative care team both directly and indirectly, turning a medical group or ACO into the palliative care team's payer. Finally, presenters will review why the palliative care field must think broadly about payment opportunities and suggest next steps.

“The Great Escape”: How an incident of elopement gave rise to trauma informed palliative care for a patient experiencing multiple disadvantage.

“…Responding to M's great escape, the hospice eventually adopted a trauma informed approach to his care (13). However, opportunities to avert his great escape may have been missed.…”

“…(10) While trauma informed care gained prominence in the early 1990s (11), its application to palliative care is relatively new (12). The prevalence rate of PTSD in patients facing a serious illness (16-18%) is estimated to be double that of the general population (8%), yet there remains a lack of routine screening for trauma related symptoms in the palliative care population (13). To support the development of trauma informed care in the palliative care specialism, there is an urgent need for examples of good practice and skills demonstrated by trauma informed palliative care teams (14).…”

Turner syndrome mosaicism: Challenges in identification and management in primary care

“…Genetic counseling requires a team and method for communicating in a trauma informed process that helps families cope with trauma of the initial information about the genetic condition (Havermans et al, 2015;Sheets et al, 2011;Witt & Jankowska, 2018;Jackson, 2020;Huang et al, 2018). Provider preparation includes knowing and providing supportive connections to the resources.…”