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Four Seasons Compassion for Life awarded $9.5 million grant

Four Seasons Compassion for Life has been selected by the Center for Medicare and Medicare Innovation to receive a $9.5 million grant for a pilot Medicare reform program.

The nonprofit was notified Thursday that it was the only hospice and palliative care provider in the nation chosen to implement health care reform over a three-year period through its innovative community care model designed to deliver better care outcomes and lower costs, according to a news release.


“I think it’s honestly an accumulation of 15 years of work,” said Dr. Janet Bull, chief medical officer with Four Seasons Compassion for Life. “We have become a national leader in delivering palliative care and in our research. As we got more known and began publicizing and reporting what we have done in terms of quality and service to patients, we started getting more national attention.”

An award-winning hospice and palliative care industry leader, Four Seasons maintains a consistent track record of reducing costs while improving patient outcomes during serious, life limiting illness, the release states. In conjunction with its collaborative partner, Palliative Care Center and Hospice of Catawba Valley, Newton, Four Seasons will test a new model for community-based palliative care across the continuum of care spanning inpatient and outpatient settings.

An estimated 8,000 Medicare beneficiaries and their families will receive integrated health services in Western North Carolina through the project. Of these, 78 percent will receive care through Four Seasons and 22 percent will receive care through Palliative Care Center and Hospice of Catawba Valley. The precise grant award is $9,596,123.

The grant funding is expected to begin around July 1, but Four Seasons has already started work.

"We’re already getting on the drawing board,” said Bull. “We’re doing a lot of the things right now, but this will certainly allow us to expand. Another piece is that the community of Hendersonville has been so supportive of Four Seasons and the work we’ve done. Not only financially, but we have around 400 volunteers. It’s a mission for many people in the community who have supported us along this journey.”

The Four Seasons community palliative care model (CPC) removes barriers to patient care due to location, economic status, ethnicity or minority status and fragility of medical condition. The model features interdisciplinary collaboration and the integration of palliative care into the health care system, continuity of care, and long-term individualized support fo patients and families — with the ultimate goals of increased quality of care and decreased hospital readmissions.

"Historically, the CPC model has been shown to improve outcomes for patients as well as the experiences of family and professional care providers," said Dot Moyer, chairman of the Four Seasons Board of Directors. "Four Seasons is being given an opportunity to prove the value of palliative care, and not only to the healthcare industry. The patients and families we serve report high satisfaction with their care experiences. Now the high quality of care for which we're known will become increasingly valued and more widely available, not only in western North Carolina, but nationwide."

Clinical and financial results of the project will be monitored through partnership with Duke University. The findings will translate into potential finance models to assist Medicare beneficiaries who struggle with advanced, life-limiting illnesses. The data generated will also provide national benchmarks for other palliative care organizations to improve patient outcomes.

The awarded project, formally titled "Increasing Patient and System Value with Community-based Palliative Care," results from a community-academic partnership between lead investigators Janet Bull, M.D., chief medical officer with Four Seasons, Don Taylor, Ph.D., of the Duke Sanford School of Public Policy, and Amy Abernethy, M.D., of the Duke Center for Learning Health Care and the Duke University Medical Center. This project is the latest in a long line of productive collaborations between Four Seasons and Duke University that Bull and Abernethy began nearly a decade ago.

"Our goal is to translate this experience into a new palliative care financing approach to Medicare, one which is sustainable and replicable," says Bull.

The implementation of the CPC model and the palliative care financing approach are expected to save the federal government more than $29 million in cost of care annually.

Current evidence demonstrates that palliative care yields overall cost savings for Medicare while improving outcomes, said Chris Comeaux, chief executive officer of Four Seasons.

"The top 10 percent of Medicare beneficiaries account for over half of total program spending, and more than one-quarter of that spending is incurred during the last year of life," he says. "The project is expected to directly reduce costs of care for patients with advanced or life limiting illness."

The "Triple Aim" of higher quality, better service and lower costs are an achievement to which healthcare providers aspire. With its partners at Palliative Care Center and Hospice of Catawba Valley, Duke University, and other providers across western North Carolina, Four Seasons commits to making that aim a reality for the residents of its communities, said Comeaux.

“That’s what this is all about,” said Bull. “Achieving the ‘Triple Aim.’ We deliver patient-centered care with shared decision making. How we can do that better. I think it was interesting to the folks at the innovation center. We will be looking at ways we can change the way health care is delivered. Deliver higher quality care where patients and families are satisfied and it costs less.”