Nearing the End BCBS Members with Advanced Illnesses to Receive Enhanced Benefits

Few times are more stressful than the approaching end of a loved one’s life, and decisions must be made about the right care.
To ease that process, Blue Cross Blue Shield of Massachusetts (BCBS) recently announced the launch of a comprehensive program aimed at improving quality of life for individuals and families facing advanced illnesses and the end of life.
“Nothing is more personal and difficult than the decisions people have to make when they face an advanced illness,” said Andrew Dreyfus, BCBS president and CEO. “Our new Complete Care for Advanced Illness program is designed to enhance patient-clinician communication during those critical times and to support high-quality, compassionate care that honors people’s values and preferences.”
Beginning this year, Blue Cross will:
• Expand coverage for conversations between members and their clinicians about planning for advanced illness and end-of-life care. Blue Cross already pays medical providers for having these conversations and will now also pay behavioral-health providers in recognition of the important role they can play in facilitating difficult discussions;
• Support increased education and training on how to prepare for advanced illness and end-of-life care, with initiatives aimed at Blue Cross members, their families, and the clinicians who care for them;
• Enhance member benefits to encourage earlier and expanded use of hospice care; and
• Introduce a new program to help members with advanced illness receive high-quality palliative care for the prevention and relief of suffering in their own homes. The program is being developed with input from clinicians and patients and families.
Research has shown that timely advanced illness care, with a strong emphasis on patient-clinician communication, can result in better quality of life and satisfaction as reported by patients and families, better coping by bereaved family members, care that is more aligned with a patients’ wishes, a greater likelihood of remaining safely at home, and even some increase in survival time.

Other Steps
Blue Cross also announced it is partnering with Ariadne Labs, which has developed a new, patient-centered approach to improving communication between critically ill patients and their clinicians through its Serious Illness Care Program.
A joint center of Brigham & Women’s Hospital and the Harvard T.H. Chan School of Public Health, Ariadne Labs develops scalable solutions to addresses failures in healthcare systems at the most critical moments in people’s lives, incLuding childbirth, surgery, and serious illness.
“A key part of our mission is to improve the lives of people with advanced illness by encouraging more, earlier, and better conversations about their values and priorities for their care,” said Dr. Atul Gawande, the nonprofit research group’s executive director. “The support we’re getting from Blue Cross will help broaden the scope of our program by introducing it to thousands of doctors and other clinical professionals who care for Blue Cross members.”
In keeping with this multi-faceted approach, Blue Cross is also collaborating with physicians and researchers to design measures for monitoring the quality of advanced-illness planning and patient care and will offer courses on care planning and communication to its 3,600 employees through partnerships with the Conversation Project and Honoring Choices Massachusetts.
The Conversation Project, co-founded by Pulitzer Prize winner Ellen Goodman and launched in collaboration with the Institute for Healthcare Improvement (IHI) and the Cambia Health Foundation, is a public-engagement campaign that aims to have every person’s wishes for end-of-life care expressed and respected.
According to the Centers for Disease Control and Prevention, although most people, if given a choice, would prefer to spend their final days at home surrounded by loved ones, about 70{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of people die in hospitals, nursing homes, and long-term care facilities. Because too many people die in a manner they would not choose, and too many of their loved ones are left feeling bereaved, guilty, and uncertain, the Conversation Project offers people resources to begin talking with their loved ones about their wishes and preferences before a medical crisis occurs.
Meanwhile, Honoring Choices Massachusetts is a nonprofit organization providing healthcare planning information and tools to inform and empower adults to make a healthcare plan and connect to person-centered care in their community.

Bottom Line
Dreyfus noted that Massachusetts has led the nation in expanding access to healthcare coverage, reforming the way doctors and hospitals are paid and setting statewide goals for healthcare spending. He believes advanced illness care offers a similar opportunity.
“Our program is designed to help individuals with advanced illness receive high-quality care that honors priorities and preferences, and to lessen the burden on critically ill patients and their families,” he said. “Many other organizations and individuals in our state are working toward the same goals, and I believe that our efforts, collectively, could make Massachusetts a national model.”