Lightbridge Medical Associateshttps://lightbridgemedical.com/resources/2017-07-16T21:36:40.663523-07:00Providing Palliative Care in San DiegoFeatured in Huffington Post: Why Some Patients Aren’t Getting Palliative Care2017-07-16T21:36:40.659772-07:002017-07-16T21:36:40.663523-07:00Developers Unplug Studiohttps://lightbridgemedical.com/resources/author/developer/https://lightbridgemedical.com/resources/featured-in-huffington-post-why-some-patients-arent-getting-palliative-care/<p>Palliative care services remains scattershot in U.S. healthcare, but access is gradually improving.</p>
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<p>By <a class="bn-clickable" data-beacon='{"p":{"lnid":"Michael Ollove","mpid":1,"plid":"http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/about/michael-ollove"}}' data-beacon-parsed="true" href="http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/about/michael-ollove" rel="nofollow" target="_blank">Michael Ollove</a></p>
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<p><a href="http://www.huffingtonpost.com/entry/why-some-patients-arent-getting-palliative-care_us_59638a8be4b0cf3c8e8d5a4d" target="_blank"><strong>Click here for the full Huffington Post article</strong></a></p>
<p>Jeannee Parker Martin’s mother will be 99 this year, and she still lives alone in the house in the Midwest where she raised her children. At 92, she was diagnosed with a slow-moving breast cancer to go along with her vascular disease.</p>
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<p>Despite those serious conditions, doctors did not think Martin’s mother was near death, which meant her Medicare plan, like many health plans, did not cover what’s known as palliative care — treatments intended to provide relief from the symptoms and stress of serious chronic disease, such as pain, nausea, dizziness, anxiety and depression, as opposed to the disease itself.</p>
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<p>A visiting palliative care nurse likely would have detected and tended to the sores that periodically developed on her legs because of her vascular illness. At least three times over the last four years, Martin said, they became open wounds that required intensive rounds of treatment at an outpatient hospital clinic.</p>
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<p>“If someone had been visiting her, it would have not only prevented these wounds from developing but saved tens of thousands of dollars to treat them,” said Martin, who lives in California and asked that her mother’s name and state not be mentioned to protect her privacy. Martin said her mother was not eligible for any other home visitation services under her Medicare plan.</p>
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<p>Palliative care has been shown to increase patients’ satisfaction with the care they receive and to save on medical expenses by reducing the need for hospitalizations and trips to the emergency room. One <a class="bn-clickable" data-beacon='{"p":{"lnid":"study of homebound, terminally ill patients","mpid":2,"plid":"http://geriatrics.ucsf.edu/files/in_home_palliative_care_JAGS_0208.pdf"}}' data-beacon-parsed="true" href="http://geriatrics.ucsf.edu/files/in_home_palliative_care_JAGS_0208.pdf" rel="nofollow" target="_blank">study of homebound, terminally ill patients</a> with a prognosis of approximately a year or less to live, plus one or more hospital or emergency department visits in the previous year, found that the average cost of care for those receiving palliative care services — $95.30 per day — was less than half the cost for those without palliative care — $212.80.</p>
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<p>Despite <a class="bn-clickable" data-beacon='{"p":{"lnid":"dramatic growth","mpid":3,"plid":"http://online.liebertpub.com/doi/10.1089/jpm.2015.0351"}}' data-beacon-parsed="true" href="http://online.liebertpub.com/doi/10.1089/jpm.2015.0351" rel="nofollow" target="_blank">dramatic growth</a> in the number of hospitals providing such care over the last decade, full palliative care services remain unavailable to many patients. But those who work in the field say they are encouraged by several developments over the last five years.</p>
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<blockquote class="content-list-component pull-quote">Despite dramatic growth in the number of hospitals providing such care over the last decade, full palliative care services remain unavailable to many patients.</blockquote>
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<p>The federal government has used recent demonstration projects to make palliative care more available to patients like Martin’s mother who have serious illnesses but are not in hospice care or hospitalized. And a small but growing number of Medicare and private health insurance plans now offer palliative care services to those patients.</p>
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<p>Several states have enacted laws to require physicians, hospitals and nursing facilities to provide patients with certain serious illnesses with information on palliative care and where to get it. Some have also adopted consumer protections to assure the quality of the palliative care delivered.</p>
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<p>California has gone the furthest. Gov. Jerry Brown, a Democrat, signed a law in 2014 that will require all Medicaid managed care plans in the state to begin offering <a class="bn-clickable" data-beacon='{"p":{"lnid":"full palliative care benefits","mpid":4,"plid":"http://www.leginfo.ca.gov/pub/13-14/bill/sen/sb_1001-1050/sb_1004_bill_20140925_chaptered.htm"}}' data-beacon-parsed="true" href="http://www.leginfo.ca.gov/pub/13-14/bill/sen/sb_1001-1050/sb_1004_bill_20140925_chaptered.htm" rel="nofollow" target="_blank">full palliative care benefits</a> starting next year.</p>
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<p>And in Congress, bipartisan sponsors last month introduced a <a class="bn-clickable" data-beacon='{"p":{"lnid":"bill","mpid":5,"plid":"https://www.congress.gov/bill/115th-congress/senate-bill/1334/text"}}' data-beacon-parsed="true" href="https://www.congress.gov/bill/115th-congress/senate-bill/1334/text" rel="nofollow" target="_blank">bill</a> in the House and the Senate that would expand existing pilot projects in Medicare to extend <a class="bn-clickable" data-beacon='{"p":{"lnid":"community-based palliative care services","mpid":6,"plid":"http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2015/08/05/in-40-states-a-new-focus-on-end-of-life-care-and-counseling"}}' data-beacon-parsed="true" href="http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2015/08/05/in-40-states-a-new-focus-on-end-of-life-care-and-counseling" rel="nofollow" target="_blank">community-based palliative care services</a> delivered by teams of doctors, nurses, social workers and chaplains to patients who are not in hospice care.</p>
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<p>“I’m encouraged by the forward movement,” said Jill Mendlen, president and CEO of LightBridge Hospice and Palliative Care, whose doctors and nurse practitioners, Mendlen said, conduct about 175 palliative care visits a month in the San Diego area. But, she said, inadequate insurance coverage still prevents many patients from getting all the palliative care services they need.</p>
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<p><strong>Definition Problem</strong></p>
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<p>Medicare, Medicaid and most private health insurers provide a full array of palliative care services for patients who are hospitalized or in hospice care, including pain management, care coordination, 24-hour help lines, advanced care planning, and social and spiritual services. Their families are also usually eligible for caregiver support services. (Under Medicare rules, to be hospice eligible, patients must be willing to forgo curative treatment.)</p>
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<p>The same is not true for patients with serious, debilitating conditions who are not hospitalized or in hospice, which is generally for people who are expected to live six months or less.</p>
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<p>Many insurance plans cover some palliative care services, such as pain management. But they tend not to cover services delivered by registered nurses, social workers and chaplains. Many Medicare, Medicaid and private insurance plans offer scant or no coverage of home visits, coordination of care, wound care, social and spiritual counseling, 24-hour hotlines, advanced care planning and family support.</p>
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<p>This is particularly true when the insurance plan is a “fee for service” plan, which means providers are paid for each treatment or procedure. Managed care plans, under which providers are paid a lump sum each month to cover the care of each patient, are more likely to cover palliative services.</p>
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<p>“If you are not terminally ill and ready to elect hospice, access to palliative care services is really limited,” said Sharon Pearce, vice president for public policy for the National Hospice and Palliative Care Organization.</p>
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<p>There appears to be no organized political opposition to the use of palliative care, and most medical specialists working with patients who have advanced diseases incorporate palliative medicine into their care.</p>
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<p>Several factors may explain why palliative care is not more widely available. It is a relative newcomer in the field of medicine, and it only became a board-certified medical specialty in 2006. Several studies have found that the <a class="bn-clickable" data-beacon='{"p":{"lnid":"number of specialists doesn’t meet the need","mpid":7,"plid":"https://www.ncbi.nlm.nih.gov/pubmed/21145468"}}' data-beacon-parsed="true" href="https://www.ncbi.nlm.nih.gov/pubmed/21145468" rel="nofollow" target="_blank">number of specialists doesn’t meet the need</a>.</p>
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<p>There is also some confusion about exactly what palliative care is.</p>
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<p>“The field itself hasn’t yet defined who should get it, what it is, and who provides it,” said Judy Thomas, the CEO of the Coalition for Compassionate Care of California, which advocates for palliative care and hospice services.</p>
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<p>Many patients and even doctors shy away from turning to palliative care because they associate it with terminal disease and the abandonment of hope for recovery. Another complicating factor is that the same services are often referred to as “palliative care” or “hospice care,” depending on who is receiving them.</p>
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<p>“There was this fantastic moment when people recognized the value of palliative care, but it got mixed up with hospice and this idea that it should only be available to people when they are dying,” said Allison Silvers, vice president of payment and policy for the Center to Advance Palliative Care, which works to increase access to palliative care.</p>
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<p><strong>California Goes Furthest</strong></p>
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<p>California has done more than other states to encourage palliative care. Since 2001, California has required most physicians to complete 12 hours of continuing education courses in pain management. And in 2014, it enacted a law making palliative care services available to the state’s Medicaid managed care population, which represents about three-quarters of the state’s Medicaid beneficiaries, or 10 million people.</p>
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<p>The law was to take effect next January, but the Brown administration pushed back implementation another six months to give state officials additional time to complete regulations laying out who will be eligible for the palliative care services, what those services will entail, who can provide them, and the costs to the state Medicaid agency.</p>
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<p>Most states already provide broad palliative services to children with advanced illnesses through Medicaid or the Children’s Health Insurance Program. While states have not moved to require insurers to reimburse palliative care, some have sought to spread information about the benefits of palliative care or assure its quality.</p>
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<p>Since 2010, Massachusetts, New York and Oregon have adopted measures to require providers to educate patients with serious illness about the benefits of palliative care and how to access that care. In 2014, Colorado set statewide standards for facilities that provide palliative care.</p>
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<p>Recently, the federal government began demonstration projects that extend palliative care to desperately ill patients who would have been considered eligible for hospice care, but were not willing to give up on curative treatment. The bills in Congress would expand that eligibility even further, to patients with advanced illnesses but for whom death is not considered so imminent.</p>
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<p>“There is promise that we will get to a place where we will be able to pay for the comprehensive palliative care services patients and families need,” said Phil Rodgers, a palliative care doctor at the University of Michigan. He chairs a task force at the American Academy of Hospice and Palliative Medicine focused on devising reimbursement methods it hopes the Centers for Medicare and Medicaid Services will consider to pay for comprehensive palliative care services for more patients.</p>
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<p>Jeannee Parker Martin says she has belatedly come to appreciate the value of full palliative care services. Her mother became eligible for hospice care late last year as her overall health deteriorated, which entitled her to the services of a visiting palliative care nurse.</p>
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<p>“Since then,” Martin said, “her wounds have been under control, and she hasn’t had to go to the hospital once.”</p>
</div>LightBridge Medical Associates, Health Net Awarded California HealthCare Foundation Grant2015-11-26T21:48:43-08:002015-11-26T21:48:48.172137-08:00Stephanie Seitleshttps://lightbridgemedical.com/resources/author/steph/https://lightbridgemedical.com/resources/lightbridge-medical-associates-health-net-awarded-california-healthcare-foundation-grant/<p align="center" class="Body"><b>LightBridge Medical Associates, Health Net Awarded California HealthCare Foundation Grant</b></p>
<p align="center" class="Body"><i>Funding allocated to implement</i><i> community</i><i>-based palliative care in a managed care environment</i></p>
<p class="Body"><b>San Diego-November 2015 - </b>LightBridge Medical Associates, in partnership, with Health Net is pleased to announce that they have been awarded a two-year grant from the California HealthCare Foundation to implement a community-based palliative care program. This grant follows an initial planning grant awarded in 2014. </p>
<p class="Body">The program grant, “Health Insurers and Palliative Care Providers: New Models of Care,” is one of seven grants awarded in California.</p>
<p class="Body">The grant program is bringing palliative care to Health Net’s most medically complex and frail members in San Diego County to add an extra layer of care management and support. The focus of palliative care is to improve the quality of life for a patient and their family through the relief from the symptoms, pain and stress of a serious illness, regardless of diagnosis. It is appropriate at any stage of an illness and can be provided along with curative treatment. Research shows that people often live longer when they receive palliative care along with other treatments.</p>
<p class="Body">“While medical advances have provided great benefit to some, many people with serious illnesses can still experience physical and emotional distress as well as lack of alignment between their personal values and the medical care they receive,” says Kate O’Malley, Senior Program Officer with the California Healthcare Foundation. “Multiple <a href="http://online.liebertpub.com/doi/abs/10.1089/jpm.2013.0153">studies</a> have shown that specialized palliative care services address these needs in a way that usual care alone does not. With a focus on defining and adhering to patients’ goals of care, managing pain and symptoms, addressing psychosocial and spiritual issues, and coordinating care among multiple providers and settings, palliative care improves the quality of life and experience of care for people with advanced illness.”</p>
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<p><b>About Lightbridge</b></p>
<p class="Body">LightBridge Medical Associates (LBMA) has been providing palliative care to patients since 2009. LBMA was the first palliative care specialty medical group in San Diego and one of the first in the nation. Their affiliated company, LightBridge Hospice, is Joint Commission accredited and has been providing hospice services throughout San Diego County for well over a decade.</p>
<p class="Body">For more information please call LightBridge Medical Associates at (858) 458-2993 or visit our website at <a href="http://www.LightBridgeMedical.com">www.LightBridgeMedical.com</a>.</p>
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<p><b>About Health Net</b></p>
<p>Health Net, Inc. (NYSE:HNT) is a publicly traded managed care organization that delivers managed health care services through health plans and government-sponsored managed care plans. Its mission is to help people be healthy, secure and comfortable. Health Net provides and administers health benefits to approximately 6.1 million individuals across the country through group, individual, Medicare (including the Medicare prescription drug benefit commonly referred to as “Part D”), Medicaid and dual eligible programs, as well as programs with the U.S. Department of Defense and U.S. Department of Veterans Affairs. Health Net also offers behavioral health, substance abuse and employee assistance programs, and managed health care products related to prescription drugs.</p>
<p>For more information on Health Net, Inc., please visit Health Net’s website at <a href="http://cts.businesswire.com/ct/CT?id=smartlink&url=http%3A%2F%2Fwww.healthnet.com&esheet=51222115&newsitemid=20151112005096&lan=en-US&anchor=www.healthnet.com&index=9&md5=4f680102f99988c90cb1e018a45f68ec">www.healthnet.com</a>.</p>
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<p class="Body"> </p>NEWS RELEASE2015-11-11T09:40:52.865196-08:002015-11-11T09:40:52.876734-08:00Stephanie Seitleshttps://lightbridgemedical.com/resources/author/steph/https://lightbridgemedical.com/resources/news-release/<p align="center"><b>Palomar Health Partners with the Elizabeth Hospice and <br/>Lightbridge to improve Palliative Care</b></p>
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<p><b>San Diego, Calif.</b> – Palomar Health, along with LightBridge Medical Associates and The Elizabeth Hospice, is forming a unique collaboration to improve the care of palliative patients in North San Diego County.</p>
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<p>The organizations have combined their expertise and experience in this medical specialty to create an unprecedented inpatient Palliative Care program at Palomar Health. This partnership will produce exceptional quality of care to the communities served by Palomar Health.</p>
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<p>For people with serious illness and their families, palliative care is specialized medical care that focuses on providing relief from pain and other symptoms and supporting the best possible quality of life for the longest possible time, no matter the diagnosis. Palomar Health’s Palliative Care Consultation services are offered to hospitalized and emergency department patients.</p>
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<p>“We believe this new three-way collaboration will bring a comprehensive and robust palliative care program to Palomar Health, and we are all committed to the program’s success,” says Maria Sudak, Interim Vice President and Chief Nursing Officer at Palomar Medical Center.</p>
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<p>Palliative care physicians from LightBridge and The Elizabeth Hospice are available 24/7 to consult with patients, being onsite Monday through Friday from 8 a.m. to 5 p.m., and on-call after hours and on weekends. This means a palliative care physician from either organization will be available to discuss treatment options at all times, in order to provide the best care plan for the patient, with comfort being the top priority. The consultation services will be offered at Palomar Medical Center first, expanding to Pomerado Hospital at a future date. </p>
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<p>The goal of palliative care is to improve the quality of life for both the patient and the family. It is appropriate at any stage in a serious illness and can be provided along with healing treatment.</p>
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<p>“While medical advances have provided great benefit to some, many people with serious illness can still experience physical and emotional distress, as well as lack of alignment between their personal values and goals and the medical care they receive,” says Kate O’Malley, senior program officer with the California Healthcare Foundation. “Multiple <a href="http://online.liebertpub.com/doi/abs/10.1089/jpm.2013.0153">studies</a> have shown that specialized palliative care services address these needs in a way that usual care does not. With a focus on defining and adhering to patients’ goals of care, managing pain and symptoms, addressing psychosocial and spiritual issues, and coordinating care among multiple providers and settings, palliative care improves the quality of life and experience of care for people with advanced illness.”</p>
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<p>Hospice is for a patient who has a terminal prognosis and is no longer seeking curative treatment. It focuses on relieving symptoms and providing support during the last months of life. While all hospice services includes palliative care, palliative care is not always the same as hospice and can be provided for those living with complex diseases or illnesses who do not have a terminal prognosis.</p>
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<p>“We are thrilled to have been chosen by Palomar Health and are very excited about this venture,” says Jill Mendlen, President and CEO of LightBridge Medical Associates and LightBridge Hospice. “We know our teams will do a wonderful job collaborating and working together to build an effective, high-quality palliative program.”</p>
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<p>Research shows that people often live longer when they receive palliative care along with other treatments focused on treating their illness. </p>
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<p>"Our collective expertise in the field of palliative medicine means an exceptional care experience for the communities served by Palomar Health,” says Jan Jones, President and CEO of The Elizabeth Hospice. “We are honored to have been chosen by Palomar Health to participate in this important program.”</p>
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<p><strong>About Palomar Health</strong><br/> Palomar Health is the most comprehensive health care delivery system in northern San Diego County and the first California member of the Mayo Clinic Care Network. It is the largest public healthcare district by area in the state, with more than 500,000 residents, and is governed by a publicly-elected board of directors. Palomar Health has several facilities serving North County, including hospitals in Escondido and Poway, expresscare health clinics in Escondido, San Elijo Hills and Temecula, and a skilled nursing facility in Poway. The health system provides medical services in virtually all fields of medicine, including primary care, cardiovascular care, emergency services, trauma, cancer, orthopedics, women’s health, rehabilitation, robotic surgery and bariatric surgery. For more information about Palomar Health, please visit <span style="text-decoration: underline;">www.PalomarHealth.org</span>.</p>
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<p><strong>About The Elizabeth Hospice</strong></p>
<p>The Elizabeth Hospice (http://elizabethhospice.org) is the oldest and largest nonprofit hospice and palliative care provider of medical, emotional and spiritual support to the seriously ill and their families, serving San Diego and the Inland Empire. Since 1978, The Elizabeth Hospice has touched the lives of more than 90,000 individuals in the communities it serves. Specialty services include its nationally recognized Pediatric and Perinatal Hospice Program and Veterans Outreach Program. Through the Center for Compassionate Care of The Elizabeth Hospice, comprehensive counseling and grief support services are available for all ages to the community-at-large, regardless of the type of illness or death experienced. For more information about The Elizabeth Hospice, call (800) 797-2050 or visit our online communities via our<strong> <a href="http://www.elizabethhospice.org/">Website</a>, <a href="http://www.facebook.com/theelizabethhospice">Facebook</a>, </strong><strong>and</strong><strong> <a href="http://www.twitter.com/ThElizabethHosp">Twitter</a>.<br/> <br/> </strong></p>
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<p><strong>About LightBridge Medical Associates</strong></p>
<p>LightBridge Hospice is Joint Commission accredited and has been providing hospice services throughout San Diego County for well over a decade. Their affiliated medical group, LightBridge Medical Associates (LBMA) has been providing palliative care to patients since 2009. LBMA was the first palliative care specialty medical group in San Diego and one of the first in the nation. They are currently participating in a two- year grant program, “Health Insurers and Palliative Care Providers: New Models of Care,” funded by the California HealthCare Foundation. For more information please call LightBridge Medical Associates at (858) 458-2993 or visit our website at <a href="http://www.LightBridgeMedical.com">www.LightBridgeMedical.com</a>.</p>Partnering for Palliative Care in California: By Kate O'Malley2015-04-08T14:09:58-07:002015-04-08T14:17:15.288723-07:00Stephanie Seitleshttps://lightbridgemedical.com/resources/author/steph/https://lightbridgemedical.com/resources/draft-article/<p><span style="line-height: 1.428571429;">Health care provider organizations, payers, and the health policy community increasingly recognize the deficiencies in care for people with serious illness and for those approaching the end of life. While medical advances have provided great benefit to some, many people with serious illness still often experience physical and emotional distress, as well as lack of alignment between their personal values and goals and the medical care they receive.</span></p>
<p>Multiple <a href="http://online.liebertpub.com/doi/abs/10.1089/jpm.2013.0153">studies</a> have shown that specialized palliative care services address these needs in a way that usual care does not. With a focus on defining and adhering to patients’ goals of care, managing pain and symptoms, addressing psychosocial and spiritual issues, and coordinating care among multiple providers and settings, palliative care improves the quality of life and experience of care for people with advanced illness, while also lowering costs by helping patients stay in the care setting of their choice (typically their home).</p>
<p>Despite robust evidence of the benefits of palliative care, growth of these services has been stunted by the lack of sufficient, defined funding streams. Only some members (typically physicians or advance practice nurses) of <a href="http://online.liebertpub.com/doi/abs/10.1089/jpm.2004.7.611">interdisciplinary palliative care teams</a> can bill for their services; one <a href="http://archinte.jamanetwork.com/article.aspx?articleid=486867">study</a> found that billing covers less than half of outpatient palliative care service costs.</p>
<p><a href="http://healthaffairs.org/blog/2015/03/25/partnering-for-palliative-care-in-california/?cat=grantwatch" target="_blank">READ MORE</a></p>