The Blog to Transform Advanced Care
Advancing Care through Innovation, Observation and Collaboration.
Earlier today, Representative Earl Blumenauer (D-OR-3rd) convened a group of advocates, including C-TAC representatives, to discuss serious illness care in the wake of the COVID-19 pandemic. Rep. Blumenauer has a long record as a leader for issues around serious illness, palliative care, hospice, and end of life care. The roundtable considered a wide range of issues while presenting viewpoints on the affect that the pandemic has had on caring for people with serious illness and their caregivers. Participants offered solutions to help improve care and ensure that all Americans with serious illness receive high-quality care consistent with their goals and preferences from diagnosis to end of life.
C-TAC representatives commented on our coalition’s support of Rep. Blumenauer’s Patient Choice and Quality Care Act (PCQCA) and the need for the Congressman and advocates to push the key committees to consider this bill, particularly in light of what we have seen and learned from the pandemic. The bill’s focal points; serious illness payment models, advance care planning, quality measurement, and public engagement have gained significance in light of the unprecedented challenges our healthcare system has faced. Further, at the core of C-TAC’s policy agenda is a commitment to advancing equity; for example, removing financial obstacles to quality serious illness care for low-income minority individuals, such as cost-sharing and deductibles for advanced care planning counseling under Medicare.
The Congressman heard from aging and consumer groups, providers of home care and hospice, PACE, POLST, and hospital advocates, and a local provider in Oregon. These participants covered topics that intersect with our 2021 Policy Agenda:
Care and Payment Models: During a dialogue about the need for payment models that better address serious illness, C-TAC representatives encouraged the Congressman to look at an approach that would ensure that all models support quality serious illness care including palliative care and community-based supports and services provided by the aging network. It was suggested that an additional capitated payment may be necessary to ensure that appropriate palliative care and home and community-based non-medical supports and services are provided.
Telehealth: Several organizations brought up the need to continue some of the telehealth flexibility for providing care, treatment, training, and assessment that came out of the pandemic. C-TAC representatives mentioned extending the pandemic telehealth allowances that help those with serious illness, such as permanently allowing coverage of Medicare advance care planning services delivered via audio-only telehealth (i.e., via traditional phone). Also mentioned was face to face hospice recertification using telehealth. The need to better fund health information technology and electronic health record portability, including ACP documents was addressed.
Caregiver Support: The need for additional resources to support the caregivers of those with serious illness was a recurring theme, including the significant value in respite care.
Workforce Issues: A number of issues were considered related to the workforce including shortages in registered nurses and primary care physicians and the need for more training and flexibility in using other professionals for some roles. Strengthening and expanding the workforce to better care for people with serious illness through programs for career development were advocated, along with training across settings.
Rep. Blumenauer was an active participant in the discussion and plans on pulling key recommendations together as he continues his work on budget reconciliation and reintroduction of PCQCA and other bills. He challenged the group to consider what kinds of standards and oversight are needed to address quality differences in the hospice space. He voiced his desire to keep the issues around quality serious illness care bipartisan even in light of the retirement of Representative Phil Roe and Senator Johnny Isakson, who were steadfast partners.
Our team of policy experts is monitoring the outcomes of this important roundtable. Stay tuned for more and learn more about our policy and advocacy work here!