A national task force, chaired by EDC’s Mildred Z. Solomon, issued a call today to managed care organizations to improve the care of dying patients. In its new report, the National Task Force on End-of-Life in Managed Care recommended 12 steps for improving care for the terminally ill.

The Task Force is chaired by leading end-of-life researcher, Mildred Z. Solomon Ed.D., director of EDC’s Center for Applied Ethics and Professional Practice. Task Force members include leaders from the managed care industry, palliative care experts, ethicists, and quality improvement specialists. This is the first time that such an interdisciplinary group has come together to consider how to harness the features of managed care in order to improve the care that patients receive in the final phase of life.

In its new report, Meeting the Challenge: Twelve Recommendations for Improving End-Of-Life Care in Managed Care, the Task Force urges action in three areas: improving access to humane and effective end-of-life care; strengthening accountability on the part of plans and providers; and developing and evaluating payment methods that will properly compensate plans and providers for the costs of caring for gravely ill patients without compromising access or quality.

“End-of-life care has been an intractable problem across the United States, and many sectors of American society have to contribute to improvements,” explains Solomon. “Managed care forms of health care delivery present special opportunities for reform.”

Specifically, the Task Force recommends that managed care organizations:

• Provide a wide range of managed care insurance products that cover end-of-life care for patients and their families.
• Create specific programs for patients dying of chronic, degenerative conditions, and ensure that these programs consider the needs of families as well as patients.
• Focus their continuous quality improvement efforts on the clinical aspects of end-of-life care, instead of deploying those resources primarily to improve administrative efficiency.
• Take pro-active steps to enhance the palliative care knowledge and skills of their medical and nursing leadership and social work staff.

To achieve these goals, the report calls for concerted action among managed care leaders, employers and other purchasers, as well as policy makers and researchers. For example, according to Solomon, “Aging baby boomers are now experiencing the challenge of attending to their elderly parents’ and spouses’ – and sometimes their own – declining health, while juggling job and family demands. It’s crucial for employers to understand the economic and social burdens on their workers and to seek out and purchase benefits that can help ease those burdens – comprehensive, end-of-life care that attends to the medical, social, and psychological needs of patients and families.”

In addition, the report calls on policy makers and researchers to:

• develop valid, standardized measures for assessing the quality of end-of-life care and calls for public disclosure of the resulting data to purchasers and consumers;
• study alternative payment methods to ensure that managed care providers and plans are properly compensated for the care of gravely ill patients;
• foster more creative relationships between managed care organizations and hospices to ensure that palliative care services are offered soon enough to patients who can benefit.