What patients can expect from Carelon’s palliative care
Palliative care focuses on providing patients comprehensive, whole-person support at any stage of their illness. Patients receive personalized care plans tailored by a multidisciplinary team of healthcare professionals, aimed at managing patients’ symptoms, improving patients’ quality of life, while integrating their pre-existing treatments into a seamless care plan.
Not to be confused with hospice care, palliative care is specialized medical care that provides physical, emotional and spiritual support for people living with chronic conditions or serious illness. The treatment helps people manage physical symptoms and emotional stressors, focusing on the patient's goals for care, values and their priorities.
The primary goals of Carelon’s palliative care program, and how they differ from those of hospice
The World Health Organization defines palliative care as treatment that optimizes patient quality of life, while alleviating patient suffering. “We want to understand what a patient needs, the stage of illness they are in, and meet them where they are to develop a treatment plan,” says Ryan Jozwiak, MD, Market Physician, Midwest, Carelon Health. “We talk them through the trajectory of their illness, as diseases tend to follow a certain cycle.”
Dr. Jozwiak makes the distinction between palliative and hospice care. “Our services are not hospice care. Hospice is for end-of life,” he emphasizes. “Carelon’s palliative care services provide full person, whole health treatment via a team who can help patients meet their goals, as part of a patient’s curative treatment plan. We enhance the patient’s pre-existing plan, if they have one in place. The patient receives a diverse team comprised of nurses, doctors, social workers and the appropriate specialists, to provide treatment or guidance. If the patient has other providers, we work with them – we don’t replace any of them.”
In palliative care, the patient may still want to explore treatment options. “We explore care options with the patient and their loved ones, determining the best choices based on the individual’s needs and preferences,” he says.
How Carelon’s palliative care services are unique
Carelon’s treatments vary widely, as part of palliative care. “Our treatment ranges from direct symptom management to providing medicines to manage oncology diagnoses. Our nursing staff makes frequent check-ins on patients experiencing cardiac issues. We also provide the patient with resources for mental health care and food insecurity. One of our main goals is to safely keep the patient out of the hospital and the ER whenever possible,” Dr. Jozwiak explains. “We also provide the patient a 24/7 hotline on which they can reach us.”
What patients and their families can expect during the initial consultation and subsequent visits with a Carelon palliative care team
Dr. Jozwiak explains how the initial consult is for gathering information on the patient. “The initial consult is about an hour in duration. During that time, our main goal is to understand the patient through their environment, their experience, and what we call their ‘lived space.’ We identify what has changed over time. A person is not their disease, so we not only focus on the medical diagnoses, but who the patient is. We help them to thrive above their illness.”
More in-depth discussions take place over the following visits. “We typically follow up the next month, spending about a half hour or so with the patient. We discuss advance care planning, conversations with the care team about the patient’s specific illness, medications and the future treatment plan.”
He points out how Carelon adapts all follow-up appointments according to the patient's needs, in addition to providing the patient and their loved ones with the 24/7 access line. “We can also see them every week or two if needed, addressing their symptoms, if they are entering a new chapter or more serious phase of the illness. We integrate care plans so that the patient receives the right care in the right place at the right time. For example, we can help craft a plan with the oncology team, to make the patient’s quality of life better, or coordinate our check-ins before or after a patient’s dialysis, or on the weekends. We maintain flexibility so that we can navigate the change with the patient, together.”
How Carelon supports family members
Research indicates that palliative care not only helps to improve outcomes for patients, but also that of their families.
“We help overwhelmed families think of questions they want to ask the specialists, especially if families have several specialists with whom they need to meet,” explains Dr. Jozwiak. “If a patient is experiencing an illness such as a UTI or pneumonia, we help the family member act as an advocate so that they are empowered to make decisions, determining when their loved one needs to go to the hospital or the ER, as well as how to keep patients at home as much as possible.”
When a patient is referred to Carelon’s palliative care program
The palliative care program is about helping patients to achieve more positive outcomes, as defined by the patient. Dr. Jozwiak recalls specific cases. “For some people it’s as simple as their being able to be at home for life events, such as making it to their daughter’s wedding. One of our APPs (Advanced Practice Providers) helped a patient coordinate the right medications so that the patient could make an out of state visit for a family life event. The APP helped the patient to navigate treatment, conversations, and care coordination, using us as a source of support.
“At other times, we come in at a very vulnerable point for the patient. One of our patients was experiencing metastatic cancer, and didn’t want to be on video. Our APP still met with them over telehealth, and helped the patient avoid the hospital and hospice, so that they could live out their remaining weeks at home, on their own terms.”
Carelon palliative care program outcomes
Carelon’s palliative care focuses on managing patients’ comprehensive needs as they experience serious illnesses, addressing not only patients’ physical ailments but also factors like emotional distress and social needs.
Carelon Health’s collaborative approach
- Carelon’s physician led, Advanced Practice Provider (APP) field-based care program indicates a 71 Net Promoter Score1. Guided by industry benchmarks, the program offers a structured and proactive approach to care that significantly enhances the quality of life for both patients and their families. The program ensures that care aligns with patient values, reduces unnecessary hospitalizations, and provides comprehensive support, ultimately leading to a more dignified and comforting experience that puts the patient first.
- Carelon emphasizes an interdisciplinary strategy that serves patients with severe illnesses or high-risk, high-cost chronic conditions, skillfully enhancing patient and healthcare provider satisfaction while concurrently controlling and reducing healthcare costs.
Looking ahead
Dr. Jozwiak emphasizes how patients referred to the Carelon team have several possibilities in terms of the direction their care goes in. “Transitions can be scary, and we know that,” he says. “We are here to offer the patient a hand to hold, rather than taking the patient away from what they know. We support patients where they are and stay with them throughout their journey ahead.”
1 (SMG) Service Management Group, October 2024.
