“Nothing is guaranteed”

Categories: Clinical Perspectives

a portrait of Kellie

“Nothing is guaranteed.” Kelly said it, and she believes it with all her heart. But what Kelly does with this belief is pretty amazing. Since a diagnosis of stage 1B1 cervical cancer during her pregnancy in 2010, she’s undergone several surgeries, chemo, radiation, and an ileostomy. But those are just her clinical activities. Time with her daughter Ava, now in the third grade, is her most precious gift. And because of her palliative care team, Kelly and Ava can have this valuable time together, to go camping, to go to the beach, and even to take two dream trips later this year.

Palliative care, designed to provide supportive care for patients who suffer from chronic, serious, and terminal illnesses, can provide improved quality of life if introduced alongside treatment of advanced illnesses. Kelly began her journey with Transitions PalliativeCare in 2017 when her need for symptom management, goals of care, and treatment recommendations elevated. Every two weeks, Kelly receives visits from her nurse Marie, and Ava can spend time with social worker Kennetra who helps her with “anticipatory” grief as well as issues specific to being a kid with a very sick mom.

Unlike hospice, a service typically fully covered by Medicare, Medicaid, and most private insurance policies, palliative care is considered a medical specialty and carries a 20% co-pay. Thanks to a pilot program between Blue Cross and Blue Shield of North Carolina (Blue Cross NC) and Transitions PalliativeCare, Blue Cross NC is covering the 20% so patients like Kelly can focus on living, rather than focus on the stress of paying for additional, needed care. This pilot ensures patients can have a full spectrum of providers – a nurse, social worker, nurse practitioner, spiritual care counselor, and nurse aide – and with more frequent visits, if necessary. And, this pilot opens the door for patients who are younger than traditional palliative care patients to receive needed care and the supplementary care.

Following a career in management and sales, including car sales where she excelled, Kelly became too ill to work on a daily basis. Marie says Kelly comes to “one hurdle after another, but she always wins.” Winning to Kelly means being able to drive Ava to school, to take walks with friends, to attend church, and to occasionally meet friends for coffee. She credits these “wins” to not only her Transitions team, but to Blue Cross NC, whose belief in high-quality palliative care services provides Kellie with the additional support she needs to overcome her hurdles.

As Marie says, “you can’t just be a robot. It’s important for our patients to know we’re listening and we care.” That’s where Kelly’s social worker, Elizabeth, comes in. She was a crucial partner in working with Jamie’s Dream Team to ensure Kelly and Ava could have something to look forward to: trips to Walt Disney World and Mackinac Island later this year. Palliative care assures patients of a comprehensive circle of expert care and support, and Elizabeth’s research and persistence paid off in the form of not one, but two trips of a lifetime.

In this time of rising health costs, of changing models of care, and the changing face of healthcare systems, providers such as Blue Cross NC and Transitions PalliativeCare who are willing to work together to identify policyholder and community needs – and provide solutions – are paving the way for a brighter healthcare future.

This is only part of Kelly’s story. Great thanks to all at Blue Cross NC and Transitions PalliativeCare who provide compassionate care and are willing to think outside the box to ensure the door is open to innovative payment models – and a continued passion for patient care.

–Darcy B., Transitions LifeCare

Blue Cross NC, cancer, healthcare, Medicaid, Medicare, palliative care
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