Overcoming Barriers to Growth in Home-Based Palliative Care

Abstract

Background: Home-based palliative care fills a critical gap between acute care (during crises) and hospice care for seriously ill patients. As of 2018, home-based palliative care capacity in the United States has not scaled to meet patient needs.

Objectives: The Center to Advance Palliative Care (CAPC) conducted a needs assessment to catalog and analyze barriers to growth in the field of home-based palliative care.

Methods: Home-based palliative care program leaders were surveyed and interviewed to elicit information about program characteristics, barriers to meeting national palliative care quality standards or to program growth, and essential elements of program sustainability.

Results: Home-based palliative care program leaders cited their major challenges as being: a lack of clarity on the applicability of national standards to home-based programs, a lack of sustainable financing methods for home-based palliative care, and lack of awareness of existing support resources for program design and leadership development.

Conclusions: Home-based palliative care programs will benefit from improved professional awareness of national quality standards and existing technical assistance. New prospects for alternative payment models that allow for sustainable interdisciplinary home-based care represent a promising opportunity for the field.

Keywords: home-based palliative care; quality standards; reimbursement.