When it comes to advance care planning (ACP), not all care plans are created equal. The range of what constitutes ACP spans from patients attempting to complete advance directives on their own to in-depth conversations about future care facilitated by clinicians. 

With so much inconsistency surrounding the definition of ACP, it can be difficult for health plans to gauge the quality of their members’ care plans. However, achieving high-quality care plans is crucial if health plans want to reap the full benefits of ACP, such as:

In this article, we’ll break down the 5 must-have elements for high-quality care plans that will set health plans, members and physicians up for success. 

  1. Timing

Initiating ACP conversations early in an individual’s care journey maximizes its benefits for both health plans and members. In fact, one study from the New England Journal of Medicine found that seriously ill patients who received early ACP services achieved both higher quality of life and longer survival times despite receiving less aggressive treatment when compared to patients that participated in ACP on the standard timeline.

The results of this study make sense; members are more likely to make informed, empowered care decisions if given ample time to think their choices over, discuss with loved ones, pray, make financial plans, etc. Rather than making crucial care decisions in the middle of the health crisis, early ACP enables members to set care goals that truly align with their goals. 

  1. Context

Beyond timing, there are a number of external factors that can influence whether or not someone is ready to have a conversation about care preferences. For example, if someone has recently lost their job or underwent a major surgery, they may not have the physical or emotional capacity to handle advance care planning conversations. 

In these cases, it pays to wait for when the timing is right. When members are ready to return to the conversation with clarity, they’re more likely to make thoughtful care decisions. 

  1. Support

ACP is not just for people with serious illnesses; their families and caregivers are key players in this process as well, and they should be included in ACP conversations from the outset. Oftentimes, these individuals bring crucial insights to the conversation, acting as a sounding board for the member as they work through their care goals. 

Additionally, including family members and caregivers in the ACP process ensures they know exactly what members want if they are ever in a position to make care decisions on their behalf. This increases the chances that members’ care plans are actually followed. 

  1. Delivery

The delivery of ACP is a crucial — yet often overlooked — factor in creating high-quality care plans. ACP facilitators should use respectful, person-centric language, allowing the member to lead the conversation feeling comfortable and empowered. 

Likewise, the language of advanced directives can be confusing and foreign for people that are not familiar with legal and medical terminology. Humanizing this language during ACP conversations is key to helping members understand what their options are and how their choices will affect their care. 

Delivering ACP in this way takes time and experience. Unfortunately, many physicians lack the training to carry out ACP to this standard. As an alternative to the physician-led model, ACP facilitated by a specially trained third-party has been proven to yield lower emergency department visits, fewer hospital stays and reduced total costs while boosting member satisfaction scores. 

  1. Documentation

Finally, the documentation generated by ACP conversations is a critical factor in determining the quality of advance care plans. ADs alone are often too generic to truly capture member wishes with respect to their unique health circumstances. Crafting disease-specific documentation that goes above and beyond state-required forms can help plans capture the full scope of member care goals. 

At Iris, for example, we’ve created an additional ACP document that goes in-depth into member care goals, accounting for disease-specific scenarios that will arise long before the timeline of a traditional AD. This document distills all of the information gleaned across multiple care planning conversations, providing a simple, easy-to-understand source of truth for members, caregivers and physicians.

Creating high-quality advance care plans with Iris

Simply creating and signing advance directives is not enough to maximize the benefits of ACP for health plans and members. To truly achieve cost savings and improve the member experience, plans must invest in measures to create high-quality care plans across their entire high-need, high-cost member population.

Iris specializes in creating high-quality, industry-leading care plans. Our team of trained experts ensure each of the five elements above are accounted for in every care plan, helping health plans achieve the maximum ROI for their investment and providing members with a tailored, person-centered experience. Our Premier ACP solution has been proven to boost member satisfaction, reduce unnecessary utilization and drive significant cost savings.

Learn more about the ROI of Iris ACP in our case study.

If you’d like to see how Iris can help your health plan achieve high-quality care plans, get in touch with us today.