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Aetna’s Compassionate Care Program Lends a Hand During Difficult Times

November 05, 2018 | Health Insurance

Life is unpredictable, and the end of it can be even more so. Advanced age and/or serious illness can feel like it arises suddenly, leaving patients and their families unprepared and in crisis. That’s why Aetna has worked for over a decade to find empathetic and supportive ways to help people make difficult choices about end-of-life care.

“Nothing is more personal than how we want to face the end of our lives,” said Alena Baquet-Simpson, M.D., Senior Director of Medical Health Services for the Aetna Medicare team. “We are committed to ensuring that individuals receive the kind of timely and compassionate care that they wish for and deserve.”

Aetna’s Compassionate Care program provides not only help with coordinating needed services, but also the empathy members and their families need during these trying times. The program offers members and families comprehensive care management and caregiver support that allows the critically ill member to face end of life on their own terms–without unnecessary stress or discomfort.

Importantly, the Compassionate Care program expands the window for many members in Commercial lines of business to receive hospice care from the typical six months to a full year. It also allows these members to receive medical treatment such as chemotherapy along with palliative care or hospice services.

The Importance of Knowing Your Options

According to Baquet-Simpson, patients or loved ones often only learn about their hospice options after a medical crisis or hospitalization. In fact, according to recent research, only 1 in 3 adults has done any advanced planning to cope with end-of-life matters.

Aetna hopes to change that dynamic by using sophisticated predictive modeling to identify patients who may be at risk for advanced illness and are candidates for advanced care planning. Highly trained professionals at Aetna then reach out to those members or their families to start a conversation about available options, information and support. Nurse case managers then work closely with members to help them understand their care options, the philosophy behind and services offered under hospice and how everything may fit with their end-of-life wishes.

For example, one member was returned home after hospitalization and a lengthy skilled nursing facility stay. The Aetna nurse case manager educated the member and his family about covered services, including home health care to help with changing wound dressings. She also ensured his questions concerning copays and network providers were answered in a timely way and engaged an Aetna social worker to identify additional community resources.1

After much discussion, the member and his family came to realize that the care he required exceeded the family members’ abilities, and he was subsequently placed in an assisted living facility. At that point, he began considering hospice. After the member passed away peacefully under hospice care, his daughter reached out to the Aetna nurse to share the family’s gratitude.

“When you are making these huge life choices, you want emotional and medical support to allow you to get your affairs in order,” said Nancy Snyder, Aetna Case Manager RN. “If things turn bad, not only do you have time to prepare, but to make sure your wishes are met. Aetna has a very forward-thinking attitude that has helped many families deal with one of life’s hardest periods.”