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Palliative Care

Recommendation:

Palliative care services are available to patients either on-site or by referral.

Overview

Palliative care refers to patient- and family-centered care that optimizes quality of life by anticipating, preventing, and treating suffering (National Quality Forum [NQF]). ;The availability of palliative care services is an essential component of cancer care, beginning at the time of diagnosis and being “continuously available” throughout treatment, surveillance, and, when applicable, during bereavement.

  • National Comprehensive Cancer Network (NCCN): “recommends screening every patient for palliative care needs”

“Therefore, it is the Panel’s expert consensus that combined standard oncology care and palliative care should be considered early in the course of illness for any patient with metastatic cancer and/or high symptom burden.

Palliative care services include, but are not limited to, the following:

  • Team-based care planning that involves the patient and family.
  • Pain and non-pain symptom management.
  • Communication among patients, families, and provider team.
  • Continuity of care across a range of clinical settings and services.
  • Attention to spiritual comfort.
  • Integrative therapies.
  • Psychosocial support for patients and families.
  • Bereavement support for families of patients who die and team members who provided care to the person who died.
  • Hospice care: Hospice care is one aspect of palliative care and is a service delivery system that provides palliative care for patients who have a limited life expectancy.

Standard/Accreditation

American College of Surgeons Commission on Cancer, Optimal Resources for Cancer Care: 2020 Standards, Standard 4.5 Palliative Care Services

Certifications

Resources to Help

Caseload Benchmarks

No data currently available. Varies widely from program to program.

Insurance Considerations

Palliative Care services are billed like any other medical service. Bills are submitted to Medicare Part B, private insurance, and Medicaid. One large difference in the way palliative care providers bill is that they will often bill based on time rather complexity, because of the lengthy goals of care discussions. Many providers will also use the Advance Care Planning codes since much of their visit time is spent in dialogue around wishes for future care.

 
ACCC Member Program: Gibbs Cancer Center & Research Institute, Spartanburg, S.C.

In 2012, the Gibbs Cancer Center (GCC) embedded a palliative care clinic within their medical oncology practice. The GCC provided clinic space to the palliative care team and also shared experienced oncology nurse practitioners who received additional training in palliative care principles and practices to staff what became to be known as the Supportive Care Clinic (SCC).

The overall goal of the SCC is to provide whole-person care to both the cancer center's patients and their families.

Palliative Care team: Board-certified palliative medicine MDs, nurse practitioners, social worker, RN, chaplain, LPN, and palliative medicine fellows.

Clinic services:

  • Assessment and expert treatment of physical symptoms
  • Identify spiritual distress and make appropriate referral
  • Counseling and psychosocial support
  • Completion of Advance Directives
  • Disease education and realistic goals of care discussions
  • Develop a team based, interdisciplinary care plan
  • Research        

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