Rural Palliative Care Emerging as a Health Care Priority

The national Priority Partnership recently identified palliative and end of life care as one of six priorities for the American health care system—ways to eliminate harm, waste, and disparities. The 32 key health care stakeholders in the Partnership represent the public and private sectors, from the Agency for Healthcare Research and Quality to AARP.

To listen to the 10 communities present at the Minnesota Rural Palliative Care Outcomes Congress in April is to know that palliative care is taking root in rural Minnesota. Each community’s program is as unique as the community itself. Yet, the challenges are similar.

Palliative care services are being offered through hospitals, nursing homes, hospice programs, and home health agencies. Lack of medical professionals training in palliative care, collaboration between health care silos, confusion about how palliative care and hospice differ, and financing were presented as common challenges.

Rural communities have advantages over urban areas for supporting palliative care services, David Weissman, consultant for the Center to Advance Palliative Care noted. They have smaller bureaucracies, closer inter-personal relationships, a greater primary care emphasis, and greater opportunities for collaborative practice across care settings.

Stratis Health is leading the Minnesota Rural Palliative Care Initiative, in partnership with Fairview Health Services’ Palliative Care Program, with primary funding from UCare. During this 18 month learning collaborative, community teams designed a model or focus for their community to start or strengthen palliative care programs in their communities.

“Palliative care parallels the approach of Health Care Homes, with families and patients working in partnership to improve health outcomes and quality of life for individuals with chronic health conditions and disabilities,” said Anita Ngo, a health program representative on the Minnesota Department of Health’s health care home team.

Both models put the patient at the center of their care and use teams to support their care. At Lakewood Health System in Staples, as a patient’s condition goes into remission, their care shifts back to their health care home. The palliative care case manager at the hospital coordinates with the case manager for health care home coordinator at the clinic.

UCare plans to cover rural palliative care services

In a landmark announcement at the Outcomes Congress, Barry Baines, associate medical director at UCare and Minnesota Rural Palliative Care Initiative advisory committee member, shared that UCare will begin discussions with Outcomes Congress participants with the goal of reimbursing these rural providers for palliative care services.

“We’re proud to be a leader among health plans in promoting palliative care,” said Baines. “We feel it’s imperative to support and expand this emerging field within the health care community.”

UCare hopes that its leadership spurs other health plans to include reimbursement for the palliative care services that are now available in these communities.

Rural Palliative Care Community Development

Stratis Health continues its partnership with UCare to build palliative care capacity in rural Minnesota communities through two new projects.

Through a Rural Palliative Care Community Development Project, six rural communities from around Minnesota will be selected to participate in a 10- month project to start or strengthen palliative care services in their communities. To be eligible for the project, a community must be served by a hospital with 100 or fewer licensed beds. Application deadline is May 28, 2010. Application information >

Funding will also support the development of a publicly available online resource center aimed at fostering palliative care in rural communities. Many resources are available on palliative care, but this is the first Web site to focus on palliative care to meet the unique needs of rural communities. The site will build on the evidence-based, actionable resources gathered for the communities in Stratis Health’s Minnesota Rural Palliative Care Initiative.