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Quality or Length of Life? Members Can Achieve Both with ACP

Tuesday, October 13, 2020

When people with serious illnesses are faced with the option to improve quality of life or length of life, many feel pressured to choose one or the other — but recent evidence shows that advance care planning (ACP) can help individuals achieve both outcomes simultaneously. 

This does not mean ACP is a magic bullet that will miraculously extend life. Rather, ACP is a crucial service that health plans can implement to help members, their caregivers, families and physicians identify what to do at the point in which the “default” treatment plan becomes more harmful to the member’s health than their illness alone. ACP provides an actionable plan for this important juncture that is designed around the member’s unique goals of care. 

Without ACP,  physicians and/or family members have been proven to default to more intense treatments for seriously ill individuals, often failing to account for the member’s wishes or evaluate if the benefits of the treatment outweigh the costs. This results in unwanted and unnecessary care that reduces both quality and length of life for members. 

Let’s take a closer look at some of the studies that demonstrate how ACP effectively increases both quality and length of life.

ACP: Improving One-Year Survival Rates

A 2019 study published in BMJ Supportive and Palliative Care examined the impact of ACP on one-year survival rates for seriously ill patients. In the randomized controlled trial (RCT), the researchers discovered that patients who participated in ACP had a 16% higher one-year survival rate after the intervention than patients who did not. This study was the first RCT to indicate that participation in ACP alone is enough to significantly improve length of life for people with serious illnesses, regardless of any other factors. 

Early Intervention Improves Quality and Length of Life

Another study from the New England Journal of Medicine found that seriously ill patients who received early palliative care — of which ACP is a critical service — achieved both higher quality of life and longer survival times, despite receiving less aggressive treatment.

  • Higher quality of life – FACT-L scores (a key indicator of quality of life for the study’s population) were 7% higher for the early intervention group compared to the control group.
  • Longer survival times – The early intervention group lived 30% longer on average, despite being 64% less likely to receive aggressive treatment. 

Although advance care planning is often relegated to the end of an individual’s care journey, the results of this study illustrate the importance of initiating care planning sooner rather than later in order to maximize its benefits for both members and health plans.

Not Just Better Days: More of Them

While there are numerous studies that demonstrate ACP’s ability to improve member quality of life, the idea that ACP can simultaneously extend overall lifespan is still relatively new. These results are certainly not guaranteed for every member, but they do present an exciting opportunity for plans to deliver more value to their members by enhancing their advance care planning services.

Even better, ACP has been proven to drive savings for health plans by reducing unnecessary and unwanted care utilization. To maximize these benefits, health plans should strive to provide widespread, comprehensive ACP services, an outcome that is most easily achieved through the support of an external ACP partner. To learn more about how you can increase the number of high-quality days your members enjoy while reducing utilization and costs, check out our free guide: How Health Plans Can Reduce Unnecessary Utilization with Advance Care Planning

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