CAPC Releases 2024 Serious Illness Scorecard: A State-By-State Look at Palliative Care Capacity

America’s Readiness to Meet the Needs of People with Serious Illness: The 2024 Serious Illness Scorecard (“Scorecard”) from the Center to Advance Palliative Care (CAPC) reveals that access to quality health care for people living with serious illness continues to remain variable and is heavily influenced by geography, race, and socioeconomic factors. This inequity impacts the approximately 13 million adults and 700,000 children living with a serious illness in the United States.

The Scorecard reviews each state’s capacity to deliver high-quality care to people facing serious illness by evaluating five domains, including the availability of specialty-trained palliative care professionals; payment for specialty palliative care services; structures to advance palliative care awareness and access; basic palliative care professional education for all clinicians; and structures to meet functional and caregiver support needs. Then, the Scorecard rates each state, using publicly available information across these domains, from one to five (with five being the highest).

A briefing on the Scorecard will be held virtually on December 10 at 4:30 pm ET. To attend, please register.

Palliative care is specialized medical care for people living with a serious illness. It is focused on providing relief from the symptoms and stress of the illness. The goal is to improve quality of life for both the patient and the family. Provided by a specially trained team, palliative care works together with a patient’s other doctors to provide an extra layer of support. Palliative care is appropriate at any age and at any stage of a serious illness and can be provided along with curative and other life-prolonging treatments such as chemotherapy.

While no state has yet to achieve five stars, two states, Massachusetts and Oregon, earned the highest ratings with 4.5 stars, while six states, including California, Connecticut, Illinois, Maryland, New Jersey, and Ohio, achieved four stars. Thirteen states earned two or fewer stars, with the remaining twenty-nine states and DC earning between 2.5 and 3.5 stars. These ratings reveal that while every state has some palliative care capacity, all states have room for improvement.

Key Findings of the Scorecard Include:

• Stark health inequities related to race and income exist for people living with a serious illness, with Black Americans at the highest risk of mortality for serious illnesses like cancer and heart disease, and less likely to receive appropriate pain and symptom management.
• While palliative care has become the standard of care in large hospitals, gaps in access remain in for-profit and rural hospitals. 83.6% of U.S. hospitals with 50 or more beds report having specialty palliative care services, and this prevalence climbs to 96.2% for hospitals with 300 or more beds. However, the proportion of for-profit hospitals and rural hospitals with palliative care lags behind significantly, at 49.0% and 34.5%, respectively.
• The number of specialty-trained palliative care clinicians lags behind that of most other specialists, with 19,920 specialists across all disciplines in the U.S. with specialty certification in hospice and palliative care.
• New payment policies and strategies are advancing palliative care capacity and access; 13 states currently have legislation requiring payment for palliative care services.
• Increasing numbers of clinicians are gaining basic skills in key drivers of palliative care outcomes, including communication and symptom management. Some states have included continuing education mandates in licensure requirements, and others have incorporated palliative care content into medical and nursing board opioid training standards.

“As with so much in health care, where you live has a profound impact on the quality and availability of palliative care when living with a serious illness,” said Brynn Bowman, chief executive officer of the Center to Advance Palliative Care. “With a rapidly aging population and increasing numbers of people managing serious and chronic illnesses, it is critical that states address these gaps to ensure all patients can access the care they need.”

A Call to Action for Health Care Professionals and Policymakers

According to the Scorecard, federal and state-level policymakers could change the equation by focusing on key areas, including workforce, payment, quality/standards, clinical skill-building, and public and clinician awareness. Several states are already developing new initiatives and passing supportive legislation.

The Scorecard provides individual state reports, which help prioritize efforts to improve care for people living with serious illness within each state. These reports offer data on the current palliative care landscape with recommendations for improvement.

Access the Scorecard, which includes a full summary, key findings and recommendations, state ratings and reports, and other information.

About the Center to Advance Palliative Care

The Center to Advance Palliative Care (CAPC) is a national organization dedicated to increasing the availability of quality, equitable health care for people living with a serious illness. As the nation’s leading resource in its field, CAPC provides health care professionals and organizations with the training, tools, and technical assistance necessary to effectively meet this need. CAPC is part of the Icahn School of Medicine at Mount Sinai in New York City. For more information, visit capc.org and follow @CAPCpalliative.

Media requesting more information or an interview with an expert at the Center to Advance Palliative Care may contact John Zoccola at 267.664.2759 / [email protected]

##