As of 1 January 2023, it is possible to declare healthcare products for pediatric palliative care in hospitals. A registration guide has been drawn up for this purpose, commissioned by the Knowledge Center for Pediatric Palliative Care and the Dutch Pediatric Association (NVK)*. The registration guide discusses a number of aspects that are important for deriving and declaring palliative care for children. Sabrina Sluiter, external senior policy advisor at NVK and Knowledge Center for Palliative Care for Children, explains.

Care provided from the hospital is declared to health insurers through so-called care products. These care products are derived on the basis of diagnoses and care activities that are registered by the care providers in the electronic patient file.

As of 1 January 2023, it is therefore possible to declare new care products for pediatric palliative care in hospitals. The registration guide describes a number of aspects that are important for deriving and declaring palliative care for children. Until 1 January, care products that are also intended for adults can be used.

Sabrina: "We were able to realize this registration guide thanks to the enormous effort of the Children's Comfort Teams who participated in the data collection."

Separate care products for pediatric palliative care

Because palliative care for children is so different from palliative care for adults, the Dutch Healthcare Authority (NZa) has accepted the request to develop separate care products for pediatric palliative care. These care products have been assigned a rate by the NZa because Paediatrics is in the A segment. The latter means that the NZa calculates rates on the basis of cost price deliveries . It is essential that the cost price deliveries of the new healthcare products are correct so that the NZa can charge correct rates.

This has created an opportunity for the KCTs to show what care they provide. This is an important change, particularly for so-called paramedical assistants (i.e. those who are not doctors, nursing specialists or physician assistants).

Also new healthcare activities

In addition to the new care products, new care activities have also been introduced that are essential for registration.

• For consultations between a patient and a healthcare professional who performs the gateway function and is part of the palliative care team, care activity 190067 - consultation by a healthcare professional who performs the gateway function and is a member of the palliative care team - is registered. This care activity can therefore be registered by the paediatrician or physician assistant or nursing specialist of a KCT.
  
  
• For members of the palliative care team who are not practitioners of the gateway function, care activity 190173 - Consultation by a member of the pediatric palliative care team, excluding healthcare professionals who perform the gateway function (see 190067) - is available. This care activity can therefore be registered by the paramedical support staff of a KCT, such as the chaplain, social worker and nurse.

Good registration is important

Sabrina emphasizes: “Register properly, even if you are a nurse, social worker, chaplain (or other) of the KCT. Read the registration guide and make sure that your team's costs provide good cost prices. So that everyone contributes to the social security of the KCTs.”

Good registration gives us more insight into what pediatric palliative care is provided. In addition, good registration in combination with correct cost allocation of the costs to the new healthcare products leads to better cost price deliveries and also to correct rates.

And important: the care activity for paramedical support has also been given a role in the diversion of the new care products. So it is really important that this care activity is registered.

NB

Sabrina explains that for the purposes of claiming, the care products for pediatric palliative care can only be claimed through the registration of the diagnosis 316.9950 (316 stands for Pediatrics specialism) AND Care activity 190006 Consultation Palliative care (similar to the KCT consultation) AND a care activity for the care provided (consultation, diagnostics, etc.).

Registration of a 190006 Palliative Care Consultation is an important requirement for registration. If not, everything will fail. This also applies to adult palliative care.

Open ends

Unfortunately, it is not yet possible to register and declare aftercare, peer consultation and home visits. Aftercare is not possible, because the law states that care can only be funded during life. All care provided after the death may and cannot be registered (this also applies to adults). Sabrina: “We also see a reluctance at the NZa to develop a care activity for home visits and peer consultation. We will continue to discuss this with the NZa. The advice for now is to allocate costs incurred by the KCTs for these procedures to the care products and the cost price calculations. So that it can be discounted in the rates.”

View the registration guide here

About Sabrina

Align practice as closely as possible with the development of payment titles. That's what Sabrina likes to commit to. She does this for, among others, professional associations of medical specialists and, more recently, also for primary care and the social domain. For example, next year she will be involved in the development of client profiles for (primary) child care.

*The registration guide previously drawn up in 2020 is hereby cancelled.