UGS Palliative Care Dinner Presentation

July 13, the UGS held a Dinner Presentation at the Marriott City Creek where Dr. Bruce Smith, the Palliative Care Medical Director for Regence Blue Cross and Blue Shield was the Guest Speaker. He gave an update on Payer Innovations on Palliative Care the from Regence's perspective. It was a well attended event and Leslie Foren, our Regence representative should be complemented on her food selection. We had a lively discussion.

For the sake of some of our members who were not able to attend, I am attempting to give a summary . The key points that I was able to take from this is that Regence Blue Cross Blue Shield as well as CMS is cognizant of the importance of Palliative Care as reflected in two of Regence's programs. One is that they have set up an Education fund to train new physicians who want to go into Palliative Care. Another thing he talked about is Coding for Patient Goals of Care Discussions. One can bill separately for a Patient Goals of Care Discussion. This is reimbursed similarly to a 99214. This can be billed separately from a patient's other codes. A modifier is not necessary except in the ICU setting. The physician does not need to have a face to face encounter with the patient himself. A social worker or physician extender who is working with the physician can satisfy the requirement as long as that person is inside the facility at the same time as the physician. Also, it is not necessary to have a discussion with the patient. One can have the discussion with a caregiver. An Advance Directive is not he same as a Patient Goals of Care Discussion. Another key take away point is that although Payers are aware of how money Palliative Care saves the system. For example, avoiding just a few days of Intensive Care Unit stay would more than pay for the cost of Palliative Care. The issue is that Payers still have to abide by General Accounting Rules where Predicted Savings do not count. At present, studies are being done to validate savings that are accrued from Palliative Care. Regence's Palliative Care Program is a work in progress. The key is to be able to align financial incentives, whether it be from ACO's and other Shared Savings Program. I welcome you to ask us any questions and I can forward them to Regence Blue Cross Blue Shield and Dr. Bruce Smith.

To view an excerpt of the talk on you tube, please click on this link:

I am also attaching a copy of the Palliative Care Codes that Leslie Foren sent me and you can find them under attachments on the home page.