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Blue Shield Poster

Authors: Abisola Latona-Ugbeme, Anna Berens, Ben Scribner, Eileen Briones, Jenelle Hallock, Kim Beverly, Kristen Vallone, LaFiaun Coats

Background
Today, millions of Americans live with serious illness. People living with serious illness can be young or old; they can live for many years after initial diagnosis or be near the end of life. Although people with serious illness are a diverse group, what they have in common is a high likelihood that they will require extensive care from their families or other caregivers.

Aim Statement
Blue Shield of California provides its members and their caregivers expanded access to comprehensive community-based palliative care programs and ensures those who are seriously ill are connected to case managers trained to help them understand their care options and help them make health care decisions that are in accordance with their wishes.

Methods
In 2017, Blue Shield of California began offering community-based palliative care services as a standard service. Starting in 2018, Medi-Cal beneficiaries enrolled with Promise Health Plan, an affiliate of Blue Shield, also began providing palliative care services. Blue Shield built a statewide network of home-based palliative care providers through collaborative partnerships with provider groups and Accountable Care Organizations (ACO), offering a broad network of facility-based and home-based palliative care providers throughout the state.

This evidence-based model of care features home visits from integrated teams that include physicians, nurses, social workers, chaplains, home health aides and other specialists to form a comprehensive care team and support system for patients facing serious illness. In addition, Blue Shield trained all internal clinical staff in serious illness communication skills and improved internal authorization processes to address urgency in authorizing necessary services for members with serious illness.

Results

  • 40 California statewide contracted home-based palliative care providers (as of January 2020)
  • Over 1,500 members served from program inception to January 2020

Poster Contact: Kristen Vallone; kristen.vallone@blueshieldca.com