INTRODUCTION: A private company in Latin America with a vision to create a sustainable healthcare system that achieve better solutions and deliver enhanced healthcare value, built a Palliative care program focused on health management, coordinated care and community projects with patients and families with life-threatening diseases.

OBJECTIVES: to determine the changes in costs and level of complexity of medical services to treat terminal diseases among members of a Palliative Care program.

METHODS: retrospective cohort of 284 patients who died between August 2017 and July 2018 were analyzed. Patients who qualified for palliative care intervention according to McNamara criteria were identified. Costs per activity and level of complexity of medical attention in the last three months of life were calculated comparing subjects enrolled in a palliative care program to those receiving usual care.

RESULTS: approximately 68% (193 patients) of deceased patients were eligible for Palliative Care; of whom 85 were admitted to the program (44% of program coverage). Median survival was 31 days.

The median cost of patients with usual care was USD$ 19,131, which was 64% higher than the median cost of those in palliative care program (USD$ 11,654). In the last three months of life, medical attention complexity had differences between patients with usual care and those enrolled: high complexity decreased from 73.4% to 36.6%; medium complexity from 12.6% to 6.2%; low complexity increased from 11.4% to 20.3% and home care from 2.6% to 36.9%.

CONCLUSIONS: after one year of implementation of a Palliative care intervention, the median cost of care was reduced and there were changes in distribution of the medical attention complexity, with decreases in high and medium complexity care but increase in lower complexity care. These changes support the sustainability of healthcare, delivering enhanced healthcare value and achieving better solutions for particular situations.