Mitigate Financial Risk and Improve Outcomes in Your BPCI Episode Bundles

As a Bundled Payments for Care Improvement (BPCI) awardee participating in episodic care, your success is dependent on reducing costs and improving quality across the care continuum. Participation in BPCI improves care coordination, reduces per-beneficiary spending and provides the highest quality of care.

Bundled Payment Intervention’s Key Opportunities

How VITAS Healthcare’s Hospice Services Impact Advanced Renal Disease Episodic Care

VITAS, compared to other post-acute care providers, is uniquely positioned to impact BPCI episodic care. A referral to VITAS, with our expert, seamless transitions and care for complex patients wherever they call home, can reduce ED visits and hospital readmissions.

As a “carve-out” service in all 48 BPCI bundles, hospice offers immediate cost savings. By referring hospice-appropriate patients to VITAS, patients’ costs associated with end-of-life care are removed from the bundle.

Delivering More Efficient Episodes of Care

VITAS has been delivering value-based solutions for hospitals’ sub- and post-acute networks, ACOs and other healthcare organizations for more than 38 years. In fact, VITAS was one of the first bundled payment beneficiaries, as hospice care is reimbursed on a flat per-diem basis.

The VITAS Longitudinal Care Continuum Offers:

How VITAS Helps with Specific Conditions

Patients are eligible for hospice care based on a physician’s clinical determination of a life expectancy of six months or less, if the disease runs its expected course without interventions.

Advanced Cardiac Disease

Heart disease differs significantly from other illnesses, requiring specialized treatment approaches. The individualized hospice plan of care treats the wide range of heart disease symptoms, including shortness of breath, chest pain, weakness, functional decline and fluid status management.

The VITAS Patient-Centered Approach for Advanced Cardiac Disease:

1. VITAS interdisciplinary team's comprehensive evaluation
2. Continuation of optimal medical treatment for heart failure to prevent exacerbations
3. Utilization of inotropic medications
4. Mechanical support devices such as left ventricular assist devices and related medications

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Advanced Neurological Disease

Some patients survive a stroke and the acute hospitalization that follows, but later experience a continuous decline in clinical and/or functional status. For these patients, the prognosis is often poor and they should be evaluated for hospice care.

VITAS’ individualized plan of care addresses the patient’s physical and psychosocial wellbeing, and seeks to manage a wide variety of symptoms, including:

• Shortness of breath
• Respiratory dysfunction
• Pain resulting from stiff joints, muscle cramps, pressure on skin/joints caused by immobility
• Skin care issues
• Difficulty swallowing
• Impaired hydration and nutrition
• Difficulty communicating
• Depression or anxiety

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Advanced Lung Disease

Dyspnea, and the anxiety it causes, are distressing symptoms that patients with both restrictive and obstructive advanced lung diseases experience; they contribute to ED utilization and hospitalization. These can often be treated using a combination of clinical therapies and patient-specific, 24-hour support that hospice offers.

The VITAS Patient-Centered Approach for Advanced Lung Disease:

1. VITAS interdisciplinary team's comprehensive evaluation
2. Goals of care planning pre-emergency
3. Pharma and non-pharmacologic interventions to reduce respiratory distress
4. Upon onset of respiratory distress, VITAS responds any time, day or night, using a customized emergency protocol.

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Advanced Renal Disease

Dialysis patients are appropriate for palliative care because of their high mortality rate and high symptom burden. Many patients and families with advanced renal disease choose not to start or to withdraw dialysis for multiple reasons, particularly in patients older than 60 years. End-of-life care should also be considered when a patient has a poor prognosis, when dialysis cannot be provided safely, when there is poor performance status, or when dialysis negatively impacts a terminally ill patient’s quality of life.

VITAS’ individualized plan of care addresses the patient’s physical and psychosocial wellbeing, and seeks to manage a wide variety of symptoms, including:

• Pain
• Fatigue
• Loss of appetite
• Confusion
• Sedation
• Nausea and vomiting
• Itching
• Difficulty breathing
• Difficulty sleeping
• Anxiety
• Depression
• Volume overload
• Symptomatic dialysis treatment when appropriate

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Learn How a Partnership with VITAS Can Help Your Organization