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Allison Silvers on Payment Model Flexibility in Palliative Care

Fee-for-service payment models have not been successful in the field of palliative care, where small practices seem to work better under flexible programs like per member per month, said Allison Silvers, vice president of payment and policy at the Center to Advance Palliative Care.


Fee-for-service payment models have not been successful in the field of palliative care, where small practices seem to work better under flexible programs like per member per month, said Allison Silvers, vice president of payment and policy at the Center to Advance Palliative Care.

Transcript (slightly modified)

What are some payment models that have successfully increased access to palliative care?

What we’ve found is that the fee-for-service model clearly does not work for palliative care. Too much time is needed by the professionals, and there’s all the “unbillable” professionals. The payment model that seems to give the most flexibility is per member per month, especially for home-based palliative care where the program is taking care of a specific population. The problem with other models such as fee-for-service with shared savings is the shared savings are too remote and a number of programs are small and unwilling to take risk. So just having enough of a flexible pot of money seems to work best. 

 
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