Many of your members and their providers arenot having the conversations they should be around serious illness care, creating a missed opportunity for the plan to support them through some of their most difficult decisions.

This lack of planning often results in more aggressive and prolonged care than the member would have wanted, as well as more time in the hospital and away from family.

Even when members and providers do engage in advance care planning (ACP), instructions often are not conveyed to other care settings, such as hospice and palliative care, when they should be. Not only does this result in members receiving care that does not align with their wishes, but the knowledge that these instructions may never be followed is disheartening to the member and their family, and it can discourage providers from initiating conversations in the first place. In addition, when palliative care services are not offered, the member and their family miss out on the benefits of palliative care, which improves quality of life by focusing on providing relief from the symptoms and the stress of the illness.

As the US population ages, health care costs rise and members demand more personalized care, there is an urgent need for health plans to overcome these challenges and incorporate ACP into their standard offerings.

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