Palliative Care Free
So about 46% say they know what palliative care is according to a consumer poll we did of 13,216 – up 4% since last year – a signal that there is still a long way to go to educate the nation on caring for people with serious diseases whether they are young, old, or at the end of life. Only about a third of those who say they know what palliative care is actually do know as most others say it's hospice or "companionship," which are directionally close. 5% mentioned "pain relief” and 3% say the "study of colors" - or palette - neither of which are exactly right, but they at least suggest people are trying to care about the root of words. I'm not sure our healthcare system has really understood palliative care either, at least not until recently. Only 10 new Medicare Advantage plans offered home-based palliative care as a primarily health-related benefit last year year, but more than 150 offer some type of home-based program.
The insurer Regence BCBS in Washington state now has two teams of nurse case managers dedicated to palliative care, one for adults and one for families with severely ill children, and in our 2023 Healthcare Payer Index of Priorities palliative care made the list for the first time ever. Several companies have formed recently getting a monthly ~$300-400 case rate for palliative care, based usually on at least one RN visit home, one social worker visit, a doctor video visit, a handful of phone calls, one visit from a chaplain and work involved with collecting and reporting data. Even Medicare needs help - for the first time, Medicare is looking for comments on adding some palliative elements to the hospice benefit.
I have to admit I didn't really know what palliative care was or looked like until Ellen was getting it. This lifelong Red Sox fan taught for 35 years in Catholic schools in Boston's north shore and told me when I met her in 1998 that I could only spend an hour with her daughter, "because you are a Yankee, that's why," she said. Even now that Ellen has passed, I am still not sure I fully understand. The palliative experience is perhaps different for each family and patient but I can say with confidence that it may just look a lot like the little stuffed animal cheetah that comforted mom near the end. "That's my little guy," she said to the Cheetah. Maybe this image of a furry stuffed animal laying bedside with someone at the end ought to be the new symbol for palliative care. Maybe Cheetahs, known for their speed and independence, have been underappreciated all these years. Maybe now people will start to understand.