Financial Aspects of Outpatient Palliative Care

Outpatient palliative care, defined in this chapter as outpatient clinic and home-based care, exists across different healthcare and financing systems. Past research has highlighted its economic and other benefits, thereby demonstrating its potential to provide better care for patients at an affordable cost. Accordingly, outpatient palliative care has become a large focus of palliative care’s growth and opportunity. This chapter aims to describe an international view of the financial aspects of and business planning for outpatient palliative care. We begin with methodological considerations for economic evaluations of outpatient palliative care (i.e., costing of individual providers, service packages, indirect care services, and unpaid labour). We then include a literature review of economic analyses of outpatient palliative care, which is organized by payer system models: fee-for-service, managed care, and universal care, as well as focuses on examples from the United States, Canada, the United Kingdom, and Australia. We provide a case study of an economically and clinically successful outpatient palliative care program, ProHEALTH Care Support, which is based in the United States. This program has demonstrated effective cost savings and integration of virtual care. We discuss the emergent topic of cost savings of virtual palliative care prior to and throughout the COVID-19 pandemic. We conclude with a ‘blueprint’ for the implementation of successful and sustainable outpatient models, which features recommendations and considerations of efficiency, sustainability, and replicability. While most of the chapter is grounded in the published literature, the blueprint section combines several published reviews and the expertise of our co-authors.