A Comprehensive Case Management Program To Improve Palliative Care

Abstract Objective: The objective of this study was to evaluate the impact of comprehensive case management (CM) and expanded insurance benefits on use of hospice and acute health care services among enrollees in a national health plan. Study Design: Retrospective cohort design with three intervention groups, each matched to a historical control group. Methods: Intervention groups were health plan enrollees who died after 2004: 3491 commercial enrollees with CM; 387 commercial enrollees with CM and expanded hospice benefits; and 447 Medicare enrollees with CM. Control groups consisted of enrollees who died in 2004 prior to the start of the palliative care CM program. The main outcomes measured were the proportion using hospice, mean number of hospice days, and number of inpatient days measured through medical claims. Results: Hospice use increased for all groups receiving CM compared to the respective control groups: from 30.8% to 71.7% (p < 0.0001) for commercial members with CM and from 27.9% to 69.8% (...