As federal policymakers respond to increasing pressure to improve the value of taxpayer spending on Medicare and Medicaid, there are numerous policy opportunities in the care of people with serious illness. Palliative care is one of the few solutions that simultaneously improves care quality, reduces burden on family caregivers, and results in more cost-effective use of resources.

Both the legislative branch (Congress) and the executive branch (particularly government agencies such as the Centers for Medicare & Medicaid Services) can play a significant role in improving access to palliative care through workforce investment, reimbursement, and promoting needed research.

Use this toolkit to learn about issues and opportunities for federal action and explore recent federal palliative care initiatives that impact the care of people living with serious illness, and their families. If you have questions or suggestions, please contact [email protected].

What’s in the Toolkit

Learn about the gaps and opportunities in the U.S. health care system for improving access to quality care for people with serious illness.

Federal Policy 101

Highlights key federal policy audiences, and legislative and regulatory opportunities for action.

2019 State-by-State Report Card

2019 report on growth of hospital palliative care across the fifty states, gaps in access, and federal and state policy recommendations.

Individual State Palliative Care Reports

View your state’s report to find information about palliative care access in your state, along with recommendations to improve it.

Serious Illness Quality Alignment Hub National Strategic Plan

Consolidation of selected areas of focus and defined strategies to enhance accountability for access to palliative care and enhance the quality of those services. Center to Advance Palliative Care and National Quality Forum, 2020.

National Academy of Science, Engineering and Medicine (NASEM) Roundtable on Quality Care for People with Serious Illness

NASEM has convened experts from across the country to explore the gaps and opportunities for improving the care of people with serious illness.

Review and act on federal policy recommendations to improve access to specialty palliative care and advance quality of care for all people with serious illness.

Policy Changes Key to Promoting Sustainability and Growth of the Specialty Palliative Care Workforce
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An analysis and commentary on the future size of the US palliative care workforce and recommended policy changes to spur growth (Kamal et al.).

Opportunities for Improving Access to Palliative Care for Dual Eligible Individuals Living with a Serious Illness

Report from ATI Advisory and CAPC describing the barriers confronting dual eligible individuals living with serious illness, and opportunities for CMS, state Medicaid agencies, and D-SNP plans to promote access to palliative care.

Summary of Concurrent Care Models

At-a-glance information across nine models of simultaneous disease-directed and palliative services.

Health Equity Policy Recommendations

Compilation of policy recommendations to improve the care of Black patients living with serious illness and their families.

Recommendations for Opioid Exemptions

With federal and state guidelines increasingly restricting access to opioids, these recommendations from the Patient Quality of Life Coalition provides recommendations for how to exempt people living with serious illness

National Coalition for Hospice and Palliative Care Priorities

Legislation supported by the Coalition, aligned with the goals of quality, workforce, payment, and research

Palliative Care and Hospice Education and Training Act (PCHETA)

Federal bill addressing the workforce deficiency, public awareness and research funding by expanding physician and nurse training, and supporting research and public awareness initiatives.

Flex Your Advocacy Muscles with the Palliative Care and Hospice Education and Training Act

Blog post on promising palliative care education legislation.

Policy

Health care policy initiatives and opportunities that impact care for people living with serious illness and their families.

Payment and Program Financing

Advancing palliative care payment from both public and private payers.

National Academies of Sciences, Engineering, and Medicine (NASEM) Workshop: Building the Workforce We Need to Care for People with Serious Illness

Proceedings from the 2019 NASEM Workshop that explored challenges and opportunities related to educating, training, and retaining the full spectrum of the workforce for serious illness care.

National Academies of Sciences, Engineering, and Medicine (NASEM) Workshop: Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness

Proceedings from the 2018 NASEM workshop on new payment and delivery models people living with serious illness, particularly in community settings.

Advancing Standards of High-Quality Care for Patients with Serious Illness in America's Hospitals

A proposal to create a Medicare Incentive Program for comprehensive palliative care services in eligible hospitals.

The Need for Investment in Palliative Care Research

The National Coalition for Hospice and Palliative Care describes why investment in palliative care research is needed and priorities for moving forward.

Links to federal policy advocacy information from partner organizations.

National Coalition for Hospice and Palliative Care

Home to the National Consensus Project for Quality Palliative Care, the Coalition was founded by the leading hospice and palliative care organizations to coordinate and collaborate on issues and activities of importance to the interdisciplinary hospice and palliative care field.

Patient Quality of Life Coalition

40+ organizations working to ensure access to high quality palliative care for all people living with serious illness.

American Academy of Hospice and Palliative Medicine Advocacy Information

The American Academy of Hospice and Palliative Medicine (AAHPM) tracks critical health policy developments and works to ensure that the interests of the field are advanced in the legislative and regulatory arenas. This site is a resource to help understand key issues; stay informed; and take action on the key issues related to the field of hospice and palliative medicine.

American Cancer Society Cancer Action Network

The American Cancer Society Cancer Action Network (ACS CAN) advocates for evidence-based public policies to reduce the cancer burden for everyone. They engage volunteers across the country to ensure their voices are heard by policymakers at every level of government.

Hospice and Palliative Nurses Association Advocacy Information

The Hospice and Palliative Nurses Association (HPNA) asserts that clinicians have a responsibility and obligation to address hospice and palliative care public policy and regulatory issues that impact the health-related quality of life of patients and caregivers living with serious illness across the lifespan. HPNA acts independently and with collaborating organizations to address hospice and palliative care issues at the national, state, local, and regional levels. HPNA advocates for legislative and regulatory initiatives that align with its Four Pillars of Excellence: Leadership, Advocacy, Research and Education.

Coalition to Transform Advanced Care

C-TAC works to ensure that all individuals living with serious illness receive comprehensive, high-quality, person- and family-centered care that is consistent with their goals and values.

Implementing change at the state level. Includes 40 resources.
A coordinated effort to develop a national strategic plan to incentivize the delivery of high-quality care for people living with a serious illness. Includes 12 resources.
Tools to help payers, policymakers, and providers understand best practices for delivering quality care during a serious illness, and to identify certifications that demonstrate adherence to third-party quality standards. Includes 34 resources.

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