In early 2024, Lila Reay* was discharged from Blue Shield of California’s palliative care program after five years — her health is now stable, and she no longer needs additional support.
“It changed my life,” said 84-year-old Reay, who started using palliative care after she was released from the hospital and required close monitoring of her chronic obstructive pulmonary disorder (COPD) disease.
Blue Shield of California and Blue Shield Promise Health Plans’ palliative care program offers home-based services to members of any age with a serious illness. The program includes pain and symptom management, coordination of medical care, medical decision making, connections to resources and more. All of this is provided by a dedicated team of physicians, nurses, social workers and emotional counselors, who deliver care and collaborate with members’ doctors and family members to give an extra layer of support. It’s the type of program many don’t know exists — until they need it.
“Many people do not realize their health plan can include programs that improve their life and optimize their health if a serious health problem arises,” said Jenelle Hallock, senior manager of program and project management for palliative care at Blue Shield.
The reality of a serious illness
More than 12 million Americans of all ages live with serious illnesses and can suffer from the conditions of these long-term illnesses for months or even years. They often rely on extra care from their families and other caregivers, which can be extremely difficult for everyone.
“It can happen at any age. We’ve had members as young as 2 years old and as old as 106 who’ve needed — and benefitted from — our palliative care program,” said Hallock.
Palliative care is designed for members with difficulty getting their medical needs met in the doctor’s office. Seriously ill members can get this care while also receiving medical treatments such as chemotherapy, radiation, dialysis or surgery from primary care and specialist providers. “Palliative care is not hospice, which is specialized care for people who have a life-limiting illness,” Hallock emphasized. “Hospice focuses on quality of life when a cure is no longer possible, and when the burdens of treatment outweigh the benefits.”
Blue Shield of California and Blue Shield Promise Health Plans offer palliative care services to members in all 58 California counties. The program’s coverage offers 24/7 access to patient help and support, and home-based visits can be made in person or via video.
Providing whole-person care
For Lila Reay, the program also helped her mental health and emotional well-being, shared Hallock. “After a few months being supported by our palliative nursing care, our member requested psychological/social support from a palliative care social worker, and emotional support from the palliative care chaplain, since she could no longer attend her church.”
Fast forward to the present, when Reay is no longer a palliative care patient. “Over the past three years, she hasn’t been hospitalized or been to the emergency room, and she no longer requires supplemental oxygen,” said Hallock. “Our palliative care program met the established goals, and we are honored to have made a difference in her life.”
Reay’s story is just one example of how health and quality of life can be improved and stabilized with Blue Shield’s palliative care program.
Since Blue Shield began offering palliative care in 2017:
- 5,166 Blue Shield and Blue Shield Promise members have used the palliative care program between January 2017 and October 2024
- 52 Blue Shield-contracted palliative care provider teams support members throughout California
- The impact of palliative care for patients is significant. Among program participants who responded to surveys about their experiences (94 people):
- 81% reported an improved quality of life
- 88% reported they were very satisfied or satisfied with the emotional support provided
- 95% reported that they were satisfied with the palliative care program
“Palliative care allows seriously ill individuals to receive essential care at home and reduces trips to the emergency room or hospital,” said Hallock. “It reduces physical discomfort, improves quality of life, and makes living with a serious illness easier.”
Resources
- Palliative care: For more information about Blue Shield’s palliative care program, visit blueshieldca.com/palliativecare.
- Open enrollment: Fall is open enrollment season. Be sure you have the best health plan for your needs, and look into benefits offered, like palliative care. For more tips and information to help navigate open enrollment, check out this News Center story.
*Name has been changed, as the member wishes to remain anonymous.