how to pay for better care

1. Thai NHSO
Palliative care
payment
Dr.Kajeeratn Prug-ago
Senior Expert, NHSO

2. Transitions in life-limiting illness
Transitions
Early Disease
containment
Maintaining
function
Decompensation
Experiencing life
limiting illness
Decline and
terminal
Transitions Transitions
Dependency and
symptoms increase
Transitions Transitions
Death and
bereavement
Time
DIAGNOSIS
Modified from McGregor and Porterfield 2009
EOLCPALLIATIVE CARE
Palliative Care and End of Life Care – The Continuum

3. Post acute care
Bed based care: residential/
nursing home,SNF, hospice
Ambulatory care : OP,Day care,
rehab. Center , special clinic Care at Home
Same
and/or
in other
hospital
Health &
Social care
Palliative
ward
Acute care
Re-admission Re-admission

4. Health
promotion
Health
prevention
treatment
Chronic
care
Rehabili
tation
Home
care
Palliative
care
Capitation/
registration
Global
budget
with
point
Fee
schedule
/Fee for
service
P4P/
Quality
Provider
incentive

5. Acute
care IP
Palliative
IP
Palliative
OP
Home
care
C229,Z51.5
adj.RW=0.83
Z51.5,C229
adj.RW=0.68 capitation
Step pay
by time
Assessment

6. End of life Palliative care
Episode