Texas PCIAC 89th Legislative Report Advances Recommendations for Palliative Care in Lone Star State
February 18, 2025 | Press Release
Through the NASHP Serious Illness Institute (SII), TFA Analytics is assisting state Medicaid agencies in crafting palliative care services benefits by using demographic information and prevailing healthcare usage patterns to help them formulate a compelling rationale for advancing the benefit through their Medicaid governing bodies. Now, one of the five states in the SII – Texas – has released a report based on this work. The report “Texas Palliative Care Interdisciplinary Advisory Council Recommendations to the 89th Texas Legislature” provides recommendations offering good faith solutions to advance supportive palliative care for all Texans facing a serious illness,
TFA Joins Together for Supportive Cancer Care to Champion Equitable, Whole-Person Care for All People
September 30, 2024 | Press Release
TFA Analytics is proud to announce its membership in Together for Supportive Cancer Care, a national coalition that will work to expand early, equitable access to whole-person, supportive care for all people with cancer, regardless of where they receive care.
Supportive cancer care is a comprehensive, whole-person approach to care that ensures the needs of people with cancer and their caregivers are met at every step of their cancer journey; however, the benefits of supportive care are not currently accessible to everyone with cancer and their caregivers.
Coalition members will be working collaboratively across three focus areas of policy, research and employer support. TFA Analytics will be collaborating within the coalition’s research workstream to promote new and existing research to demonstrate the positive impact of supportive care on outcomes, quality of life and healthcare costs.
2023 Advanced Care Transformation Index (ACT Index) Now Available
June 6, 2024 | Publication
C-TAC has released its 2023 C-TAC Advanced Care Transformation Index (ACT Index). The Index provides data and trends to make your case for improving care for those with serious illness at the state and regional level and drive national change.
Implementing new policy recommendations for care delivery and services can be a multi-year, complex effort. And one of the biggest challenges our state partners have identified is securing early buy-in from policy makers, payors, foundations, and other stakeholders in an action plan. Thie Index can serve as a compass that can help give you and your fellow stakeholders objective data supporting the direction of your plan. The Index can also provide the foundation for common ground among all members of our coalition.
Hawai’i Becomes First State to Cover Palliative Care Services through State Plan Amendment
June 3, 2024 | Blog Post
On May 7, 2024, the Centers for Medicare and Medicaid Services (CMS) approved the state’s application to include community-based palliative care services as a benefit in their State Plan Amendment (SPA). This makes Hawai’i the first state to implement palliative care as part of standard care, adjusting the state’s Medicaid budget to include these necessary services. As reported by C-TAC in October 2023, this approval is hugely significant, as it paves a path to enable other states wishing to cover palliative care services as part of a state plan amendment. This policy route differs from previous ones in California and other states by successfully including CMS in the process of approval, requiring a specific standard of care available to all Medicaid beneficiaries, and standardizing the payment model so that it can be part of the state Medicaid fee schedule.
Biller Family Foundation Launches “Together for Supportive Cancer Care” Initiative
May 17, 2024 | Blog Post
According to the American Cancer Society (ACS), more than 2 million people will be diagnosed with cancer in 2024. Cancer is the second most common cause of death in the United States. While there has been a significant decrease in the rate of people dying from cancer in the US, due to earlier screening, detection, and treatment, more people are living longer with cancer and experiencing pain and other problems associated with their diagnosis and treatment. Significant disparities remain in the quality of cancer care provided and access to available treatment. While services like supportive care, including advance care planning, care coordination, and palliative care have been proven to improve the quality and length of life for people with cancer, access and coverage issues make it difficult for most people to get high quality supportive care as part of standard cancer treatment.
The 2023 C-TAC Advanced Care Transformation Index: Supporting Our State Champions to Create National Change
May 14, 2024 | Presentation
If you’re looking for data and trends to make your case for improving care for those with serious illness at the state and regional level, look to the 2023 ACT Index Report.
Implementing new policy recommendations for care delivery and services can be a multi-year, complex effort. And one of the biggest challenges our state partners identify is securing early buy-in from policy makers, payors, foundations and other stakeholders in an action plan. Think of the Index as a compass that can help give you and your fellow stakeholders objective data supporting the direction of your plan. The Index can provide the foundation for common ground among all members of our coalition.
This webinar will share updates and insights from the 2023 ACT Index Report and will offer examples for how you can use your state scorecard to develop an action plan for change.
April 19: The Week in Cancer News
April 19, 2024 | News Article
A urine test providing information on prostate cancer grade may help men with no prostate cancer or low-grade cancer that is likely to grow slowly avoid unnecessary biopsies, HealthDay reported. In a study published online April 18 in JAMA Oncology, test results from a urine-based test that examines 18 genes for signals associated with high-grade prostate cancer were found to have high sensitivity in detecting the Gleason grade of prostate cancers, indicating the likelihood of the cancer to grow and spread to other parts of the body. “If you’re negative on this test, it’s almost certain that you don’t have aggressive prostate cancer,” said co-senior author Arul M. Chinnaiyan, a pathology researcher at Michigan Medicine, in a press release from the institution.
In Two States, Transforming the Model for Palliative Care
April 16, 2024 | News Article
Approximately 150 million people in the U.S. have a chronic health condition, and two-thirds of those have two or more such conditions. Palliative care can offer them crucial support. When people are living with more than one chronic condition or serious illness, the health care system becomes a quagmire. “People in medicine tend to focus on the one organ system that they’re responsible for,” Bower said. “When you build a palliative care team that’s interdisciplinary, that team becomes this nice navigator of the health care system and the social safety net.”
A growing body of research shows that this form of care reduces physical discomfort and stress, improves quality of life for individuals and their families, and helps people stay at home rather than having to go to an emergency room. A 2010 study of patients living with advanced lung cancer, published in the New England Journal of Medicine, found that early palliative care improved their quality of life and mood. People who get early palliative care also received less aggressive treatment at the end of life — and lived longer.
2023 ACT Index Report and What this Data Means for Hawaii
April 16, 2024 | Presentation
The ACT Index (Advanced Care Transformation Index) with Torrie Fields, presenting the latest data for Hawaiʻi. Covering issues like: How is Hawaii doing in Serious Illness Care? How do we compare with other states? C-TAC developed the ACT Index as a tool to evaluate the quality of serious illness care using evidence-based measures. It allows healthcare leaders, policymakers, regulators, communities, and consumers to track progress towards improving care at the national and state-level and track its progress over time against leaders in different domains and determine the changes needed for care improvement.
Palliative Care Could be a Game Changer for Public Health
April 4, 2024 | News Article
“Being ill is like a full-time job,” says Andrew E. Kaufman, a 60-year-old author. Kaufman lives with myasthenia gravis, a neuromuscular disease, as well as other chronic conditions, and his self-care requires a lot of time—and communication. The cascade of his own needs “is frustrating and causes anxiety and a whole host of issues.”
Lucky for Kaufman, he lives in California, where he has help from a palliative care team. California is one of the first states in the country to require insurance companies that administer Medicaid benefits to fully cover palliative care services for eligible residents. Kaufman’s team, which is covered by Blue Shield of California, includes a social worker, a care coordinator (who is also a nurse), and a nurse practitioner, most of whom he is in touch with on a regular basis. They monitor his blood pressure and oxygen levels and assist with administrative tasks such as phone calls and emails to medical providers, which can be time-consuming and stressful.
Palliative Care’s Evolving Role in Medicaid
March 15, 2024 | News Article
The number of states introducing palliative care Medicaid reimbursement channels has been climbing in recent years. But questions proliferate around how to shape these programs.
More Medicaid palliative programs have evolved in recent years, but utilization of these services is not keeping pace with payment, according to Torrie Fields, strategic advisor at the Coalition to Transform Advanced Care (C-TAC). She is also CEO of Torrie Fields & Associates (TFA), a value-based health care consulting company. At the crux is a lack of awareness of these state-funded programs, Fields said at Hospice News’ Palliative Care News Conference in Tampa, Florida.
How Changing Reproductive Health Laws Could Impact Perinatal Hospice
March 8, 2024 | News Article
Evolutions in reproductive health laws may have reverberating impacts on the demand and delivery of perinatal hospice care. Perinatal hospice care is provided to families choosing to continue a pregnancy following a life-limiting prenatal diagnosis indicating a high risk of mortality before or shortly after birth. This care includes emotional, spiritual and medical support to families navigating the complexities of a terminal illness. Perinatal hospice providers work closely with health care professionals in neonatal intensive care units (NICU) and reproductive health settings.
The changes taking place around reproductive health laws have contributed to mounting concerns about the future outlook for perinatal hospice services and how those professionals collaborate with others in the care continuum to reach families in need, according to Emily Cane, manager of clinical programs at Torrie Fields & Associates (TFA)
Improving Quality of Life for People with Heart Failure through Integration of Palliative Care Services: A Pilot Project
February 29, 2024 | Presentation
Palliative care can improve the patient’s journey in heart failure. Although heart failure is a serious illness, people with heart failure have low rates of utilization. While palliative care has bettered clinical outcomes, enhanced patient, and provider experience of care, and reduced unnecessary spending, few models have focused specifically on the impact of palliative care on those with heart failure in a value-based payment system, including evaluating the appropriate time for referral to palliative care and its specific impact on outcomes related to the quality and cost of care. Recognizing this need, the American Heart Association (AHA) and the Coalition to Transform Advanced Care (C-TAC) designed the pilot project “Improving Quality of Life for People with Heart Failure through Integration of Palliative Care Services.” Join the webinar to learn about the accomplishments of the first two phases and the plans for the third phase
How to Support State Palliative Care Payment Policy Discussions
February 20, 2024 | News Article
Palliative care is hitting its stride. Leaders in the field have spent decades building up programs, articulating the value proposition, and educating decision-makers on how palliative care can help alleviate suffering. And now, policymakers at the state level are taking decisive action to expand access. This progress has been accelerated by organizations such as the National Academy for State Health Policy (NASHP), with support from The John A. Hartford Foundation, and other leaders such as the California Health Care Foundation (CHCF), who have developed resources to catalyze state official action.
C-TAC & American Heart Association Partner on Palliative Heart Failure Initiative
February 9, 2024 | Blog Post
C-TAC and the American Heart Association (AHA) launched the “Improving Quality of Life for People with Heart Failure through Integration of Palliative Care Services” initiative in 2023, bringing together a national clinical advisory council, state coalitions, health systems, and health plans in Alabama, California, Hawai’i, and Louisiana to develop a standardized palliative care referral pathway for people with heart failure.
NJ Governor Signs Medicaid Palliative Care Bill into Law
January 23, 2024 | Blog Post
New Jersey Governor Phil Murphy signed AB 5225 into law on December 21, 2023, requiring the development of a palliative care services benefit aimed to improve the quality of life for Medicaid beneficiaries with serious illness and their caregivers. The benefit will give access to needed ongoing assistance by an interdisciplinary team, including management and support for pain and other issues related to a serious illness, and to necessary care coordination and navigation services by specialists.
NY State Addressing Needs of People Facing Serious Illness Through Benefit Design
October 26, 2023 | Blog Post
C-TAC, the Hospice and Palliative Care Association of New York State (HPCANYS), C-TAC Innovations, and TF & Associates (TFA) are partnering to develop a comprehensive set of recommendations to expand access to palliative care and caregiver services in New York State through state benefit design and is funded through a grant from The Ralph C Wilson, Jr. Foundation.
Palliative Care: A State Resource Guide
October 16, 2023 | Toolkit Release
For individuals living with complex, often chronic, conditions, and their families, palliative care can provide relief from symptoms, improve satisfaction and outcomes, and help address critical needs during difficult times. There is growing recognition of the importance of palliative care services for individuals with serious illness, such as pain and symptom management, care coordination, advance care planning, and team-based, multi-disciplinary assessment and care planning. These services can help patients and families cope with the symptoms and stressors of disease, better anticipate and avoid crises, and reduce unnecessary or unwanted care. While this model is grounded in evidence that demonstrates improved quality of life, better outcomes, and reduced cost for patients, only a fraction of individuals who could benefit from palliative care receive it. This resource guide offers state officials tools and examples to increase access to palliative care in their state.
Palliative Care: FAQs for State Policymakers
October 5, 2023 | Blog Post
Many state health policy leaders are interested in increasing access to palliative care so that people who are seriously ill can get needed care, including support for their caregivers, while avoiding costly, unwanted, or unnecessary care. Nearly half of the states have a palliative care taskforce or advisory council through state legislation. Just this year, six states — Colorado, Maine, Maryland, Ohio, Texas, and Washington — applied and were selected by NASHP to participate in a two-year learning collaborative to improve care for people with serious illness by exploring a Medicaid benefit for community-based palliative care.
Throughout the past five years, NASHP, with generous funding from The John A. Hartford Foundation, has worked closely with state policymakers on palliative care. Based on our work with them, here are their most frequently asked questions … and the answers.
Medicare’s Hospice Experiment: Putting Private Insurers In Charge
August 27, 2023 | Media
Hospice doctor Bethany Snider sees the writing on the wall: “The hospice care we’ve known and loved won’t be the same 10 years from now.”
Hosparus Health, the Louisville-based hospice agency where Snider serves as chief medical officer, is one of more than 100 provider organizations partnering with some of the country’s largest health insurers on a federal experiment that could transform hospice care for millions of people.
More States Integrating Palliative Care Into Medicaid Programs
May 24, 2023 | News Article
The channels for palliative care payment may be widening as more state legislators recognize growing demand for these services and start to weave them into Medicaid reimbursement.
More than 15 states have rolled out bills to direct Medicaid agencies and other state authorities to research the ability to implement a dedicated palliative care benefit or pay for community-based versions of these services, according to Torrie Fields, strategy advisor at the Coalition to Transform Advanced Care (C-TAC).
Hawai’i’s Palliative Care Benefit: Design and Stakeholder Input
April 5, 2023 | Presentation
Torrie Fields is principal at Torrie Fields Analytics. Ms. Fields is an evaluator and health services researcher working with payors, providers, and policy makers to improve access to care for complex populations through high-value initiatives. She has led the development and implementation of the community-based palliative care (CBPC) benefit in Hawai’i and is working with organizations across the country to design and develop similar benefits for high-need Medicaid beneficiaries.
Stephanie Anderson is chief executive officer of C-TAC Innovations and executive director of Respecting Choices. Dr. Anderson has extensive experience in advance care planning, shared decision making, palliative care, and hospice. She was project director of the development and implementation planning project for a community-based palliative care Medicaid benefit in Hawai’i.
Six States Selected to Participate in NASHP State Policy Institute to Improve Care for People with Serious Illness
March 13, 2023 | News Article
NASHP, in partnership with The John A. Hartford Foundation, has selected six states to participate in its State Policy Institute to Improve Care for People with Serious Illness: Colorado, Maine, Maryland, Ohio, Texas and Washington.
The institute will engage these six state teams for two years to receive technical support from NASHP and subject matter experts on serious illness and palliative care policy. CBIZ Optumas and Torrie Fields Analytics will help participating teams with the development of state-specific actuarial models for Medicaid palliative care benefits.
Q&A: Actuarial Analysis of a Medicaid Palliative Care Benefit
February 13, 2023 | Blog Post
When state policymakers are considering a new benefit to their state’s Medicaid program, they often ask “how much does it cost?” A new actuarial analysis, written by CBIZ Optumas with contribution from Torrie Fields of TF Analytics under a subcontract with NASHP, answers this question for offering a palliative care benefit to Medicaid enrollees. The actuarial analysis, Palliative Care in Medicaid Costing Out the Benefit: Actuarial Analysis of Medicaid Experience, found that — along with improved quality of life for people with serious illness — Medicaid palliative care benefits can also yield cost savings.
Advance Care Planning Billing and Coding for Billing Clinicians
January 27, 2023 | Presentation
A Kōkua Mau presentation by Torrie Fields, CEO at Votive Health and Strategic Advisor to C-TAC. It helps social workers, physicians/APPs and their teams understand how to get reimbursed for advance care planning services and document for qualified visits. She discussed additional reimbursement opportunities for palliative care providers and their teams through current state policy efforts to expand access to team-based palliative care services for QUEST beneficiaries.
State of Reform Conference
January 20, 2023 | Presentation
Hawaii recently implemented a first-in-the-nation community-based palliative care benefit through a state plan amendment, requiring place-based palliative care to be covered as a Medicaid benefit for Hawaiians with serious medical illnesses. State of Reform had the opportunity to catch up with the founder and CEO of TFA Analytics, an organization that has been heavily involved in this effort, at the 2023 Hawaii State of Reform Health Policy Conference earlier this year.
Torrie Fields discussed the work that went into operationalizing this benefit and what it means for Hawaii healthcare.
Payors to CMMI: We Need a Standardized Definition for Palliative Care
September 6, 2022 | News Article
A group of health plans, policymakers and insurance companies recently told the Center for Medicare & Medicaid Innovation (CMMI) that they needed a standardized definition for palliative care in order to improve access.
The Coalition to Transform Advanced Care (C-TAC) recently facilitated discussions between CMMI, health plans and other private payers on ways to integrate palliative care services into existing payment models.
More than 60 participants discussed strategies to lay the groundwork for sustainable pathways to palliative care within existing health plans and payment models.
Torrie Fields, strategic advisor at C-TAC, spoke with Hospice News about the biggest takeaways of these discussions and what’s on the horizon for palliative care payment.
What Song Would You Want Played at Your Funeral?
February 9, 2021 | Publication
Angel and I were eating a rushed breakfast before a morning meeting. We’d picked a little diner in West Seattle that happened to be half record store, half greasy spoon. David Bowie’s song “Sound and Vision” played on the speakers overhead, and as I checked my Facebook feed, a post stopped me cold: “It is as if the brightest light in the universe has burnt out. We will miss you starman.” I felt a resounding “no” echo through my entire body. David Bowie was dead. “Sound and Vision” was playing as a lament.