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![Page 1: Program Development for Outpatient Palliative Care Monica Malec, MD Clinical Director of Palliative Medicine Services University of Chicago.](https://reader036.fdocuments.in/reader036/viewer/2022062407/56649e215503460f94b0d24e/html5/thumbnails/1.jpg)
Program Development for
Outpatient Palliative CareMonica Malec, MD
Clinical Director of Palliative Medicine Services
University of Chicago
![Page 2: Program Development for Outpatient Palliative Care Monica Malec, MD Clinical Director of Palliative Medicine Services University of Chicago.](https://reader036.fdocuments.in/reader036/viewer/2022062407/56649e215503460f94b0d24e/html5/thumbnails/2.jpg)
Why?
• Part of overall strategic plan
• Continuity of care
• Education
• Quality Improvement
![Page 3: Program Development for Outpatient Palliative Care Monica Malec, MD Clinical Director of Palliative Medicine Services University of Chicago.](https://reader036.fdocuments.in/reader036/viewer/2022062407/56649e215503460f94b0d24e/html5/thumbnails/3.jpg)
Who?
• Determine the patient population• Specific disease• Specific symptom• Specific services
![Page 4: Program Development for Outpatient Palliative Care Monica Malec, MD Clinical Director of Palliative Medicine Services University of Chicago.](https://reader036.fdocuments.in/reader036/viewer/2022062407/56649e215503460f94b0d24e/html5/thumbnails/4.jpg)
Where?
Embedded
• Within existing clinic
• Focused patient population
• Cost supported by host clinic
Co-located
• Shared space
• Independence to determine patients population
• Shared cost with host clinic
Stand-alone
• Unique clinic
• Independence to determine patient population
• Full responsibility for costs
![Page 5: Program Development for Outpatient Palliative Care Monica Malec, MD Clinical Director of Palliative Medicine Services University of Chicago.](https://reader036.fdocuments.in/reader036/viewer/2022062407/56649e215503460f94b0d24e/html5/thumbnails/5.jpg)
How?
• Patient scheduling• Linked vs Unlinked visits
• Billing
• Prior authorizations
• Prescription refills
• Follow up phone calls
• After hours calls
![Page 6: Program Development for Outpatient Palliative Care Monica Malec, MD Clinical Director of Palliative Medicine Services University of Chicago.](https://reader036.fdocuments.in/reader036/viewer/2022062407/56649e215503460f94b0d24e/html5/thumbnails/6.jpg)
Projected Visits
• Determine template• New Patients
• 60 minutes
• Return patients• 30 minutes
½ day = 2 new patients + 4 returns
![Page 7: Program Development for Outpatient Palliative Care Monica Malec, MD Clinical Director of Palliative Medicine Services University of Chicago.](https://reader036.fdocuments.in/reader036/viewer/2022062407/56649e215503460f94b0d24e/html5/thumbnails/7.jpg)
Projected visits
• For each ½ day • Assuming 44 weeks of clinic
• 88 new patients• 176 returns
• For 1 FTE• Assuming 8 clinics/week
• 704 new patients• 1408 returns
![Page 8: Program Development for Outpatient Palliative Care Monica Malec, MD Clinical Director of Palliative Medicine Services University of Chicago.](https://reader036.fdocuments.in/reader036/viewer/2022062407/56649e215503460f94b0d24e/html5/thumbnails/8.jpg)
Projected Billing
• Revenue generated will not cover cost
• Will be dependent on payer mix
• Typically about 50%
![Page 9: Program Development for Outpatient Palliative Care Monica Malec, MD Clinical Director of Palliative Medicine Services University of Chicago.](https://reader036.fdocuments.in/reader036/viewer/2022062407/56649e215503460f94b0d24e/html5/thumbnails/9.jpg)
Projected RVUs
CPT code RVU
Initial visit 99204 2.43
99205 3.17
Return 99214 1.50
99215 2.11
Consult 99244 3.02
99245 3.77
![Page 10: Program Development for Outpatient Palliative Care Monica Malec, MD Clinical Director of Palliative Medicine Services University of Chicago.](https://reader036.fdocuments.in/reader036/viewer/2022062407/56649e215503460f94b0d24e/html5/thumbnails/10.jpg)
Measuring Success
• Number patients served
• Timely referrals
• Improved symptoms
• Increased hospice referrals/LOS
• Decreased ER visits/admissions
• Improved patient satisfaction
![Page 11: Program Development for Outpatient Palliative Care Monica Malec, MD Clinical Director of Palliative Medicine Services University of Chicago.](https://reader036.fdocuments.in/reader036/viewer/2022062407/56649e215503460f94b0d24e/html5/thumbnails/11.jpg)
University of Chicago
• Clinic embedded in Oncology
• Co-management model
• Started with single clinic in the Advanced Solid Tumor Clinic ( phase 1 clinic )
• Now 3 clinics /week• Referrals from ASTC, head and neck, GI,GU, Lung,
MM, gyne-onc, breast• FY12 621 pt visits• FY13 663 pt visits• FY14 100 so far
![Page 12: Program Development for Outpatient Palliative Care Monica Malec, MD Clinical Director of Palliative Medicine Services University of Chicago.](https://reader036.fdocuments.in/reader036/viewer/2022062407/56649e215503460f94b0d24e/html5/thumbnails/12.jpg)
Questions?
? ? ?
? ?
![Page 13: Program Development for Outpatient Palliative Care Monica Malec, MD Clinical Director of Palliative Medicine Services University of Chicago.](https://reader036.fdocuments.in/reader036/viewer/2022062407/56649e215503460f94b0d24e/html5/thumbnails/13.jpg)
For references and additional invaluable resources:
The IPAL Project: IPAL-OP located at
www.capc.org