Approach. Built on tenets of palliative care, LifeCourse provides a whole person supportive approach.
For Who? Patients in the last few years of advanced serious illness.
How are They Identified? LifeCourse-developed algorithm using electronic health record data and/or provider referral.
Who Provides the Service? Community health workers, called care guides, attach to existing health care teams. Care guides have strong communication skills and compassion for those living with serious illness; a minimum of a high school degree; post-secondary education preferred.
What Do Care Guides Do? Meet with patients monthly in their home to facilitate conversations that:
How is it Reimbursed? Varies by locality, such as patient-centered medical home coordination fee, value-based payment, and Medicare Advantage plans.
Impact: Improved quality of life and experience of care. Reduced total cost of care.
BMC Palliative Care 2016