Anthem’s Individualized Care Program supports palliative care for commercial members

Anthem’s Individualized Care Program is available to our fully insured commercial members to provide palliative care support for members with advanced illness in the last 12 months of life.  

 

This program does not replace the care of PCPs and specialists, but provides an extra layer of support with an interdisciplinary team that includes palliative care physicians, palliative care nurse practitioners, registered nurses, social workers, chaplains and patient care coordinators.

 

Specific palliative care services include:

• Comprehensive assessments including symptoms, spiritual and psychosocial needs
• Expert symptom management
• Supporting patients in defining their goals, values and preferences and in advance care planning
• Encouraging patients to execute advance directives
• 24/7 access to urgent clinical support from an palliative care team member
• Securing needed resources
• Education on palliative services and hospice care services

An initial telephonic outreach to identified members will be made by a palliative care professional to introduce Anthem’s Individualized Care Program and to assess the level of palliative services required by the member.   The member will then be asked if they are willing to participate in one of the following three models:

1. Telehealth services and support at routine intervals to patients by palliative trained providers
2. Home based visits by a palliative care nurse practitioner, supported by an interdisciplinary team of palliative providers for patients with a high symptom burden, increased risk of hospitalization or other complex issues. The home based visits will be offered through Anthem’s partnership with our subsidiary Aspire Health (available in certain geographic areas)
3. Clinic based services offered through an Anthem partnership with our subsidiary Aspire Health. Aspire’s palliative care team will be embedded within the outpatient clinic/practice of the member’s medical oncologist to provide services to targeted patients (available in certain geographic areas)

 

Aspire Health already provides services for members with advanced illness enrolled in our Medicare and Medicaid health plans and has demonstrated improvement in quality and cost of care savings.

 

If you are an Anthem contracted network provider, an Aspire Health palliative physician may reach out to your practice to introduce themselves in order to establish a physician to physician relationship. They may also discuss developing an individualized mechanism by which to share information regarding patients that have been identified for palliative care services. Aspire will provide clinical updates to your practice on a regular basis to facilitate the best possible co-management of your patient.

 

If you have questions regarding the Individualized Care Program, please email IndividualizedCareProgram-palliativecare@anthem.com.