A report released November 19 by the Berkeley Forum finds that California hospital spending could be reduced by billions of dollars over the next eight years if patients’ wishes about palliative care were honored. The Forum—a collaborative effort involving executive leadership of major health insurers, health care delivery systems and the State of California with health policy experts from the School of Public Health at UC-Berkeley—previously issued a Vision of increased choice and better value for patients nearing end of life. The new report builds on that Vision, highlighting three major programs that give patients in California greater choice of care outside the hospital. The programs’ interdisciplinary teams incorporate patient goals and wishes when planning treatment, resulting in patient-centered care that tends to move people out of intensive hospital settings and into care in the community.
“Our review shows that offering more choices to patients can not only increase satisfaction with care and improve outcomes, but also divert spending from expensive and unwanted services,” said Eric Kessell, policy director for the Berkeley Forum and lead author on the report.
The study also found that by expanding access to community-based palliative care to over 100,000 Californians a year through 2022, more than $5.5 billion could be moved from high-cost, unwanted hospital services while honoring patient wishes for care at home and in other community settings.
“The wishes of patients, their families and loved ones should be honored at the end of life,” said Richard Scheffler, co-chair of the Berkeley Forum. “Many of them do not want to die in a hospital. This report gives them other choices.”
In order to achieve this Vision, conversations about palliative care will need to be incorporated throughout the healthcare delivery system, with increased use of nurse practitioners and other healthcare professionals, and a tripling of physicians certified in hospice and palliative medicine.
Stephen Shortell, chair of the Berkeley Forum, said, “The increased interest in palliative care is part of a larger movement toward greater patient and family engagement in all aspects of their care over the life course.”
“Expanding palliative care in California is the right thing to do on every level. It is what patients want, it improves outcomes, it lowers costs and most importantly provides compassionate relief to those suffering.”
— David Feinberg, president and CEO of the UCLA Health System and UC Health’s representative on The ForumDownload Report PDF