{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T03:21:11Z","timestamp":1794540071437,"version":"4.9.1"},"reference-count":33,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Palliative Medicine"],"published-print":{"date-parts":[[2026,12,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Health plans utilize various strategies, including benefits, network design, incentive programs, payment reform, and medical policy, to enhance the quality of medical care for their members.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Determine the benefits of palliative care, particularly within the context of an incentive-driven program for a sicker Medicare Advantage (MA) population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective cohort analysis to assess differences in outcomes between those receiving palliative care and a matched comparison. The sample consisted of Highmark MA members. The treatment group included members who had a palliative consultation during an inpatient admission, while the control group comprised members who had an eligible admission but did not receive a consultation. Patients were propensity score matched.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting\/Subjects:<\/jats:title>\n                    <jats:p>A total of 2095 matched Highmark MA members receiving care in the eastern United States between January 2020 and December 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements:<\/jats:title>\n                    <jats:p>Claims-derived total cost of care was assessed using a difference-in-differences analysis. Process measures included the number of referrals to a community-based palliative care program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The treatment group consistently had reduced costs relative to the matched controls (difference ranging from $4,485 to $4,827). Furthermore, referrals to community-based palliative care dramatically increased, with a 650% rise in 2022 and a 147% increase in 2023 compared to 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>These findings suggest that incentive-based programs, particularly when targeting sicker populations through redesigned eligibility, can effectively align financial incentives with improved palliative care delivery. This contributes to both significant cost-efficiency and enhanced patient care coordination, as evidenced by reduced costs and a substantial increase in palliative care referrals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10966218261469456","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:22:17Z","timestamp":1790140937000},"page":"1663-1670","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Health Plan Incentive Program to Improve Access to and Treatment of Palliative Appropriate Patients"],"prefix":"10.1177","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2743-4518","authenticated-orcid":false,"given":"Emily","family":"Jaffe","sequence":"first","affiliation":[{"name":"Highmark Health, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten","family":"McHugh","sequence":"additional","affiliation":[{"name":"Highmark Health, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Aiello","sequence":"additional","affiliation":[{"name":"Highmark Health, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvia","family":"Rieker","sequence":"additional","affiliation":[{"name":"Highmark Health, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amber","family":"Shergill","sequence":"additional","affiliation":[{"name":"Highmark Health, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyson","family":"Barrett","sequence":"additional","affiliation":[{"name":"Highmark Health, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"e_1_3_3_2_1","unstructured":"1.Floyd J. Value-based care a driver of palliative care investment. Hospice News; 2025. Available from: https:\/\/hospicenews.com\/2025\/01\/15\/value-based-care-a-driver-of-palliative-care-investment\/ [Last accessed: February11 2025]."},{"key":"e_1_3_3_3_1","unstructured":"2.Highmark. Unit 7: Value-based reimbursement programs. providers.highmark.com. Available from: https:\/\/providers.highmark.com\/content\/highmark\/en\/providerresourcecenter\/home\/resources-and-education\/highmark-provider-manual\/chapter-5-care-and-quality-management\/unit-7-value-based-reimbursement-programs.html [Last accessed: February11 2025]."},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2017.0164"},{"key":"e_1_3_3_5_1","unstructured":"4.Parker J. Palliative care increasingly important in value-based landscape. Hospice News; 2024. Available from: https:\/\/hospicenews.com\/2024\/06\/18\/palliative-care-increasingly-important-in-value-based-landscape\/ [Last accessed: February11 2025]."},{"key":"e_1_3_3_6_1","unstructured":"5.Vossel H. Building a \u2018more person-centered health system\u2019: Palliative care in value-based models. Hospice News; 2023. Available from: https:\/\/hospicenews.com\/2023\/10\/27\/building-a-more-person-centered-health-system-palliative-care-in-value-based-models\/ [Last accessed: February11 2025]."},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2022.0280"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.70.1474"},{"key":"e_1_3_3_9_1","unstructured":"8.National Institutes of Health. Palliative care improves quality of life. NIH News in Health; 2017. Available from: https:\/\/newsinhealth.nih.gov\/2017\/01\/palliative-care-improves-quality-life [Last accessed: December7 2024]."},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2017.0287"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/02692163231214124"},{"key":"e_1_3_3_12_1","unstructured":"11.Keller C Bakos A. NIA is leading efforts to coordinate NIH palliative care research. National Institute on Aging; 2024. Available from: https:\/\/www.nia.nih.gov\/research\/blog\/2024\/02\/nia-leading-efforts-coordinate-nih-palliative-care-research [Last accessed: February11 2025]."},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/SPC.0b013e32836103e5"},{"key":"e_1_3_3_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2023.131145"},{"key":"e_1_3_3_15_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2006.0231"},{"key":"e_1_3_3_16_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2022.0316"},{"key":"e_1_3_3_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269216318774899"},{"key":"e_1_3_3_18_1","unstructured":"17.Center to Advance Palliative Care. Community-based palliative care program design\u2014Tools and resources. CAPC; 2024. Available from: https:\/\/www.capc.org\/toolkits\/community-based-palliative-care-program-design\/ [Last accessed: February11 2025]."},{"key":"e_1_3_3_19_1","doi-asserted-by":"crossref","unstructured":"18.Sullender RT Selenich SA. Financial considerations of hospital-based palliative care. RTI Press; 2016. Available from: http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK532652\/ [Last accessed: April4 2024].","DOI":"10.3768\/rtipress.2016.rr.0027.1603"},{"key":"e_1_3_3_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2024.2754"},{"key":"e_1_3_3_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-021-00782-7"},{"key":"e_1_3_3_22_1","unstructured":"21.Vossel H. How the value in health care act could change palliative care payment\u2014Hospice news. Palliative Care News; 2024. Available from: https:\/\/hospicenews.com\/2024\/01\/03\/how-the-value-in-health-care-act-could-change-palliative-care-payment\/ [Last accessed: December7 2024]."},{"key":"e_1_3_3_23_1","unstructured":"22.Center to Advance Palliative Care. Measuring quality. National Standards for Palliative Care; 2020. Available from: https:\/\/www.capc.org\/defining-and-measuring-quality\/ [Last accessed: December7 2024]."},{"key":"e_1_3_3_24_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2017.0548"},{"key":"e_1_3_3_25_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.38.5161"},{"key":"e_1_3_3_26_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2017.0583"},{"key":"e_1_3_3_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269216319875906"},{"key":"e_1_3_3_28_1","unstructured":"27.Parker J. How hospices can leverage palliative care to \u2018stay relevant\u2019 in value-based care\u2014Hospice news. Palliative Care News; 2024. 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