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As opportunities to provide palliative care through Accountable Care Organization (ACO) relationships continue to arise, operators will likely need to understand the varying types of reimbursement that exist in that arena.
ACOs are groups of physicians, hospitals and other health care providers who come together voluntarily to give coordinated high-quality care to their Medicare patients. Hospices and palliative care providers can collaborate with ACOs by becoming members of those organizations themselves, or by contracting with them through a preferred provider network.
Community-based palliative care’s track record of reducing costs and hospitalizations could make providers of those services attractive to ACOs, according to Edo Banach, partner at Manatt Health, a division of the law firm Manatt, Phelps & Phillips, LLP.
“You have this payment for value, not necessarily payment for bundles or episodes of care, but really the value,” Banach told Palliative Care News in a recent webinar. “There’s an incentive there for folks to provide valuable care, and a reward, in a sense, for investment in things that offset more expensive care — so investments, for example, to keep people in the community and keep people out of hospitals.”