How advanced practice providers improve palliative care services

When you or a loved one face a serious illness, compassionate care and support can make all the difference. At the heart of this are the people who not only deliver medical expertise but also take the time to truly understand what matters most to each patient. In palliative care, these moments often come through the work of advanced practice providers (APPs) — highly skilled clinicians who serve as both guides and advocates through some of life’s most complex journeys. 

“Navigating the healthcare system can be very difficult,” says Deb Dorsch, manager II clinical field operations, palliative care operations leadership. “APPs support the patient’s goals and communicate those throughout the healthcare team, so that they’re treated as they want to be treated.”
 

What is an advanced practice provider?

At Carelon, APPs consist of nurse practitioners, physician assistants, and clinical nurse specialists. All types of advanced practice providers have advanced training and the ability to diagnose, treat, and prescribe medication for various illnesses. APPs work closely with physicians, registered nurses, social workers, and schedulers, but they’re the ones providing direct patient care.

“APPs are really the face of Carelon and palliative care out in the community,” Deb says.
 

What do APPs do?

When an advanced care provider first visits palliative care patients, they begin with an assessment.

“Our main focus is the physical and psychosocial needs of the patient to ensure that that they feel well enough to spend their time as they wish, as well as with whom they wish,” Deb says.

This comes to life in several ways:

• Symptom management: APPs prescribe medications and suggest lifestyle changes for patients, so they can experience relief from symptoms like nausea, pain, fatigue, and shortness of breath.
• Goals of care conversations: APPs facilitate discussions around advance care planning (ACP), helping people to plan for their palliative and end-of-life care.
• Physical care: APPs address pain management and relief from symptoms like nausea, fatigue, breathing difficulties, and insomnia.
• Emotional support: APPs provide counseling to help patients and their families cope with emotions and stress related to the illness.
• Psychological care: APPs assess mental health care needs and aid in the management of psychological issues like depression and anxiety.
• Social services: APPs determine and assist with social and practical needs, including family dynamics and support systems.
• Spiritual care: APPs offer spiritual support or guidance to address existential questions and spiritual distress.
• Cultural considerations: APPs respect and incorporate cultural preferences in the care process.
• Communication: APPs ensure clear, compassionate communication about diagnosis, prognosis, and treatment options, aligning with the patient’s values and goals as well as coordination of care.
• Ethical care: APPs consider ethics, including autonomy, informed consent, and advance care planning.
• End-of-life care: APPs focus on the needs of patients nearing the end of life, including hospice services and advance directives.
• Support for caregivers: APPs provide resources and respite care to alleviate the burden on family members and caregivers.
   

The role of an APP on the healthcare team

APPs direct what happens following their initial assessment. If they determine a patient has significant psychosocial needs, for example, they bring in a social worker for support and guidance on getting those needs met. After addressing certain symptoms, they’ll have nurses check in with the patient and make sure the patient is improving. And should a patient have complex needs, the APP will bring in a physician.

“Everybody works together, but it really is the APP who’s identifying what the patient’s needs are,” Deb says.
 

Benefits of advanced practice providers

Carelon’s Advanced Practice Provider-led Palliative Care program indicates a 74 Net Promoter Score,¹ a metric used to gauge customer loyalty and satisfaction. This results from our APPs’ commitment to alleviate suffering and provide personalized care. As part of the palliative care team, APPs ensure that patients have:

• Someone highly educated and trained to manage conditions throughout the process.
• On-call providers available at all times.
• Easier access to the care they need.

“It’s very rewarding to see people receive the care they wish to receive, that they likely wouldn’t have received if they hadn’t been involved in our palliative care program,” Deb says.

Carelon’s APP support not only delivers measurable results, but also meaningful experiences — for patients, families, and healthcare partners alike. We invite you to learn more about how Carelon is bringing compassionate, personalized care to those who need it most.