Health
In the months near the end of life, what most people want is a last chance to be themselves, in their homes, with the people they love.
Palliative care is patient- and family-centered care that anticipates, prevents, and treats suffering during end of life. And beginning Jan. 1, 2018, palliative care becomes a covered benefit for all eligible Medi-Cal beneficiaries.
The benefit gives individuals, during the period before hospice care is necessary, an alternative to spending time in hospitals and emergency rooms.
Partnership HealthPlan of California, or PHC, the Medi-Cal managed care plan for 14 Northern California counties, is pleased that its community-based palliative care pilot program, which launched in September 2015, is becoming a full-fledged benefit.
“Our pilot efforts have shown that palliative care really works,” said Elizabeth Gibboney, CEO of PHC. “Members have been able to spend their final months as they wish, at home, with the medical support they need and the family support they want. We are glad to help our members access this invaluable care.”
In PHC’s Partners in Palliative Care pilot every $1 spent to administer the pilot, $3 were saved in hospital costs. From enrollment to death, 55 percent those participating in the pilot avoided hospitalization, compared to 21 percent of matched comparison beneficiaries.
ResolutionCare and Collabria Care, which participated in PHC’s pilot program, are now among those contracted with PHC to provide palliative care services to eligible members, and more contracted providers are being added. The care they give includes assessment, pain management, care coordination, access to caregiver support, and case management.
“Our living and dying are not medical. While it’s a natural truth that we all die, the last chapter of life is better centered in our homes and with our families,” said Dr. Michael Fratkin, president and founder of ResolutionCare, based in Humboldt County. “We are proud to be a participant in the creation of palliative care capacity and access for all Partnership members, and Medi-Cal recipients across the state.”
“Palliative care increases the quality of life of all recipients, and this new benefit will increase access to this special care for thousands of patients,” said Linda Gibson, President & CEO, Collabria Care, based in Napa County. “Collabria Care looks forward to continuing their work with Partnership HealthPlan and offering community-based palliative care services to all eligible patients in our region.”
Collabria shared a palliative care success story involving a PHC member who took part in the pilot program.
The Napa County woman, in her mid-50s, had end-stage liver disease. She was given information about her diagnosis and agreed to explore counseling. She was taught skills to be in control of her own health management.
She began working with a volunteer to write her life story, and after seven months graduated from the palliative care program due to improved prognosis. She has had no ER visits or hospitalizations, has remained alcohol-free, and is enjoying her family.
Consistent with new state guidelines, PHC will offer palliative care to members with an expected survival of one year or less who have one of four diagnoses: advanced cancer, liver disease, congestive heart failure, or chronic obstructive pulmonary disease.
Some additional factors are considered in eligibility, but essentially the care is to be provided to PHC members who need more help at the end of life but who are not yet ready for hospice care.
Members must be willing to have home-based care, participate in advanced care planning discussion, and avoid hospital care and ER visits.
PHC members or their family who want to learn more about the palliative care benefit can call the PHC Member Services team at 800-863-4155 or TTY 800-735-2929 or 711.
The following palliative care organizations are currently contracted with PHC and accepting patients. More are being added, so please contact PHC for an updated list:
– ResolutionCare – Del Norte, Humboldt, Lassen, Mendocino, Modoc, Shasta, Siskiyou, Trinity;
– Collabria Care – Napa, Solano and Sonoma;
– Yolo Hospice – Yolo;
– Hospice Services of Lake County – Lake;
– Medical Home Care Professionals – Shasta;
– Continuum Hospice – Solano.
Palliative care is patient- and family-centered care that anticipates, prevents, and treats suffering during end of life. And beginning Jan. 1, 2018, palliative care becomes a covered benefit for all eligible Medi-Cal beneficiaries.
The benefit gives individuals, during the period before hospice care is necessary, an alternative to spending time in hospitals and emergency rooms.
Partnership HealthPlan of California, or PHC, the Medi-Cal managed care plan for 14 Northern California counties, is pleased that its community-based palliative care pilot program, which launched in September 2015, is becoming a full-fledged benefit.
“Our pilot efforts have shown that palliative care really works,” said Elizabeth Gibboney, CEO of PHC. “Members have been able to spend their final months as they wish, at home, with the medical support they need and the family support they want. We are glad to help our members access this invaluable care.”
In PHC’s Partners in Palliative Care pilot every $1 spent to administer the pilot, $3 were saved in hospital costs. From enrollment to death, 55 percent those participating in the pilot avoided hospitalization, compared to 21 percent of matched comparison beneficiaries.
ResolutionCare and Collabria Care, which participated in PHC’s pilot program, are now among those contracted with PHC to provide palliative care services to eligible members, and more contracted providers are being added. The care they give includes assessment, pain management, care coordination, access to caregiver support, and case management.
“Our living and dying are not medical. While it’s a natural truth that we all die, the last chapter of life is better centered in our homes and with our families,” said Dr. Michael Fratkin, president and founder of ResolutionCare, based in Humboldt County. “We are proud to be a participant in the creation of palliative care capacity and access for all Partnership members, and Medi-Cal recipients across the state.”
“Palliative care increases the quality of life of all recipients, and this new benefit will increase access to this special care for thousands of patients,” said Linda Gibson, President & CEO, Collabria Care, based in Napa County. “Collabria Care looks forward to continuing their work with Partnership HealthPlan and offering community-based palliative care services to all eligible patients in our region.”
Collabria shared a palliative care success story involving a PHC member who took part in the pilot program.
The Napa County woman, in her mid-50s, had end-stage liver disease. She was given information about her diagnosis and agreed to explore counseling. She was taught skills to be in control of her own health management.
She began working with a volunteer to write her life story, and after seven months graduated from the palliative care program due to improved prognosis. She has had no ER visits or hospitalizations, has remained alcohol-free, and is enjoying her family.
Consistent with new state guidelines, PHC will offer palliative care to members with an expected survival of one year or less who have one of four diagnoses: advanced cancer, liver disease, congestive heart failure, or chronic obstructive pulmonary disease.
Some additional factors are considered in eligibility, but essentially the care is to be provided to PHC members who need more help at the end of life but who are not yet ready for hospice care.
Members must be willing to have home-based care, participate in advanced care planning discussion, and avoid hospital care and ER visits.
PHC members or their family who want to learn more about the palliative care benefit can call the PHC Member Services team at 800-863-4155 or TTY 800-735-2929 or 711.
The following palliative care organizations are currently contracted with PHC and accepting patients. More are being added, so please contact PHC for an updated list:
– ResolutionCare – Del Norte, Humboldt, Lassen, Mendocino, Modoc, Shasta, Siskiyou, Trinity;
– Collabria Care – Napa, Solano and Sonoma;
– Yolo Hospice – Yolo;
– Hospice Services of Lake County – Lake;
– Medical Home Care Professionals – Shasta;
– Continuum Hospice – Solano.
- Details
- Written by: Editor
OAKLAND, Calif. – On Thursday, the U.S. District Court for the Northern District of California granted a preliminary injunction in State of California v. Wright, to block the Trump Administration regulations that would allow employers to exclude contraceptive coverage mandated by the Affordable Care Act from their employees' health insurance policies.
The action by a California court follows the nationwide injunction issued in Pennsylvania earlier this month.
Both the Pennsylvania and California rulings were based on the failure of the federal government to comply with the Administrative Procedures Act in promulgating its Interim Final Rule; the Pennsylvania court also based its ruling on the additional grounds of the likelihood of the Commonwealth of Pennsylvania prevailing on its substantive challenge to the Interim Final Rule. The Pennsylvania court found that the regulations "contradict the text of the statute that they purport to interpret."
“The law couldn’t be more clear: a woman, not her boss and certainly not a politician, should decide what’s best for her own healthcare,” said California Attorney General Xavier Becerra. “The Affordable Care Act guarantees that women are not burdened with high costs for seeking basic healthcare, including birth control. This court ruling serves as yet another reminder to the Trump Administration: the rule of law applies to everyone, no matter who you are or how high your rank. In concert with last week's injunction in Pennsylvania, today's ruling amounts to a one-two punch against the Trump Administration's unlawful overreach. Having said this, our work will not end until women are guaranteed the healthcare they deserve.”
California Insurance Commissioner Dave Jones submitted a declaration in this case, providing evidence demonstrating that women would be harmed if the Trump rule denying women access to contraceptives is permitted to remain in effect.
"Thanks to the Affordable Care Act, health insurance policies must cover contraceptives. Tens of millions of women across the nation benefit from the ACA provision that requires health insurance coverage of contraceptives without any copays or deductibles. Courts in Pennsylvania and now California have put in place injunctions to block regulations that would otherwise permit employers to interfere with women's right to access to contraceptives,” said Jones.
Jones said that before the ACA was in effect, he spoke to women who could not always afford to fill their prescriptions for contraceptives.
“President Trump's regulations would prevent some women from being able to make fundamental decisions about reproductive health care for themselves. Trump's rule, if allowed to stand, would deprive women of their rights and access to basic health care services, while increasing the number of unintended pregnancies and abortions. Women will suffer serious and irreparable harm if these rules are in place and we will continue to do everything in our power to prevent that from occurring,” Jones said.
California was joined in this lawsuit by the states of Delaware, Maryland, New York and the Commonwealth of Virginia.
Last Friday, Pennsylvania obtained a preliminary injunction in a similar case, Commonwealth of Pennsylvania, v. Trump, et al., U.S. Dist. Court, Eastern District of Pennsylvania, Case no. 17-4540.
The action by a California court follows the nationwide injunction issued in Pennsylvania earlier this month.
Both the Pennsylvania and California rulings were based on the failure of the federal government to comply with the Administrative Procedures Act in promulgating its Interim Final Rule; the Pennsylvania court also based its ruling on the additional grounds of the likelihood of the Commonwealth of Pennsylvania prevailing on its substantive challenge to the Interim Final Rule. The Pennsylvania court found that the regulations "contradict the text of the statute that they purport to interpret."
“The law couldn’t be more clear: a woman, not her boss and certainly not a politician, should decide what’s best for her own healthcare,” said California Attorney General Xavier Becerra. “The Affordable Care Act guarantees that women are not burdened with high costs for seeking basic healthcare, including birth control. This court ruling serves as yet another reminder to the Trump Administration: the rule of law applies to everyone, no matter who you are or how high your rank. In concert with last week's injunction in Pennsylvania, today's ruling amounts to a one-two punch against the Trump Administration's unlawful overreach. Having said this, our work will not end until women are guaranteed the healthcare they deserve.”
California Insurance Commissioner Dave Jones submitted a declaration in this case, providing evidence demonstrating that women would be harmed if the Trump rule denying women access to contraceptives is permitted to remain in effect.
"Thanks to the Affordable Care Act, health insurance policies must cover contraceptives. Tens of millions of women across the nation benefit from the ACA provision that requires health insurance coverage of contraceptives without any copays or deductibles. Courts in Pennsylvania and now California have put in place injunctions to block regulations that would otherwise permit employers to interfere with women's right to access to contraceptives,” said Jones.
Jones said that before the ACA was in effect, he spoke to women who could not always afford to fill their prescriptions for contraceptives.
“President Trump's regulations would prevent some women from being able to make fundamental decisions about reproductive health care for themselves. Trump's rule, if allowed to stand, would deprive women of their rights and access to basic health care services, while increasing the number of unintended pregnancies and abortions. Women will suffer serious and irreparable harm if these rules are in place and we will continue to do everything in our power to prevent that from occurring,” Jones said.
California was joined in this lawsuit by the states of Delaware, Maryland, New York and the Commonwealth of Virginia.
Last Friday, Pennsylvania obtained a preliminary injunction in a similar case, Commonwealth of Pennsylvania, v. Trump, et al., U.S. Dist. Court, Eastern District of Pennsylvania, Case no. 17-4540.
- Details
- Written by: Editor
How to resolve AdBlock issue?