Healthcare 360: The Integral Role of Palliative Care in Health Care

Podcast: A Discussion on Hospice and Palliative Care

On this week’s episode of Healthcare 360, Dr. Rob Fields sits down with Cynthia Ayoub, RN, BSN, CHPCA, Executive Director of Hospice and Palliative Care at Beth Israel Lahey Health At Home, Roger Schutt, DO, Medical Director for BILH At Home Hospice and Palliative Care, and Jennifer Gizmunt, President of Continuing Care at Beth Israel Lahey Health, to discuss hospice and palliative care within the healthcare field.

What Are Hospice and Palliative Care?

Before diving too deep into their discussion, the group decides they should first define hospice and palliative care for listeners, pointing out that there are many misconceptions surrounding both. To make things easy, Dr. Schutt describes hospice as a part of palliative care, but one that exists as entirely separate entity as well.

Palliative care, basically put, is working with people who have chronic illnesses that progress over time and providing them with both symptom management and support. Hospice, on the other hand, is offered when treatment becomes ineffective, and a decision is made not to pursue any further life-sustaining procedures, instead focusing on comfort and patient care. Typically, the decision to transfer to hospice comes when a patient has a life expectancy of less than six months.

Laying out the makeup of a hospice team, Ayoub identifies the patient and their family as the center of their care. “We have a registered nurse who is the leader of the team and a social worker and spiritual care,” she says. “So it’s about the emotional, physical, and spiritual care of the patient. We don’t just look at what’s causing the symptoms. We really want to make sure that we’re helping to decrease that burden of symptoms.” A hospice team also works with hospice aides and volunteers.

Palliative Care Through the Operational Lens

Though palliative care is an integral part of healthcare services, it’s not always viewed that way by insurance companies. Part of this is due to lack of funding and another driving force is, according to Gizmunt, being “undervalued by some of the payers and not recognizing the role that palliative care plays.”

She raises the point that palliative care is often seen as synonymous with symptom management, although it’s much more than that. “It needs to be valued for the full role as opposed to sort of a narrow view of symptom management, right?” she asserts. “I think if the value was there and the reimbursement was there, there would be better access, and then I think palliative care would start to play a much more prominent role.”

Although there’s clear evidence showcasing that palliative care reduces total cost of care, prevents unnecessary hospitalizations, and leads to other improved outcomes, says Dr. Fields, the payer and payment policy just hasn’t caught up yet, a struggle he likens to proving the importance of primary care to insurance companies.

Every other week, we’ll chat with a leading expert in healthcare to learn about the many challenges and opportunities facing the industry. Listen to the full conversation with Ayoub, Dr. Schutt, and Gizmunt here, and check in regularly for new episodes of Healthcare 360.