For this month, I would like to discuss an innovative program in palliative care in Addison County that unfortunately was discontinued about a year ago.
The program, called Partners in Palliative and Home Care, was begun in 2009 under the leadership of two family physicians and with support of the local hospital, Porter Hospital. The concept was to provide comprehensive high quality in-home palliative care for patients that did not meet the requirements of Medicaid for Hospice reimbursement, which include having a prognosis of less than six months to live. This program in many ways mimicked the Hospice program, with an emphasis on crafting a treatment plan to best meet the patient's goals.
I think this program exemplifies several important features of the patient-practitioner relationship. First, it shows that the two local physicians who started the program were well-acquainted with their patients and knew that there was a need for this type of service. Furthermore, they were willing to reshape their practice to go into the patients' homes in order to improve their quality of care.
Unfortunately the program closed about a year ago, not because the need for it disappeared, but because of difficulties in securing reimbursement from Medicaid.
This story reminds me that in a broken system, even good ideas can fail. I am all but certain that this program reduced hospitalizations, unwanted treatments and promoted the best possible quality of life for the patients. How ironic that it was found to be financially untenable.
http://vtdigger.org/2011/10/28/palliative-care-program-at-porter-medical-center-in-middlebury-closes/
The program, called Partners in Palliative and Home Care, was begun in 2009 under the leadership of two family physicians and with support of the local hospital, Porter Hospital. The concept was to provide comprehensive high quality in-home palliative care for patients that did not meet the requirements of Medicaid for Hospice reimbursement, which include having a prognosis of less than six months to live. This program in many ways mimicked the Hospice program, with an emphasis on crafting a treatment plan to best meet the patient's goals.
I think this program exemplifies several important features of the patient-practitioner relationship. First, it shows that the two local physicians who started the program were well-acquainted with their patients and knew that there was a need for this type of service. Furthermore, they were willing to reshape their practice to go into the patients' homes in order to improve their quality of care.
Unfortunately the program closed about a year ago, not because the need for it disappeared, but because of difficulties in securing reimbursement from Medicaid.
This story reminds me that in a broken system, even good ideas can fail. I am all but certain that this program reduced hospitalizations, unwanted treatments and promoted the best possible quality of life for the patients. How ironic that it was found to be financially untenable.
http://vtdigger.org/2011/10/28/palliative-care-program-at-porter-medical-center-in-middlebury-closes/
