States Chart A Policy Path to Improve Palliative Care Services Across The Care Continuum

Palliative care is an effective strategy to improve the quality of care and quality of life for seriously ill individuals while reducing the cost of care for these patients. Palliative care services are delivered alongside curative treatment and often include pain and symptom management, care coordination, and team-based supports. These services help patients cope with the symptoms and stressors of disease, better anticipate and avoid crises, and reduce unnecessary or unwanted care. 

While this model enjoys strong support from the evidence, fewer than 5 percent of individuals who could benefit from palliative care receive it. States, which spend more than 50 percent of their Medicaid budgets on 5 percent of beneficiaries with complex conditions, are increasingly interested in palliative care and the value it brings to systems that support individuals with serious illnesses. 

Despite the alignment of palliative care with health policy goals, states face challenges as they work to integrate palliative care across the health care continuum. The National Academy for State Health Policy (NASHP), with support from the John A. Hartford Foundation, recently convened a State Leadership Council on Palliative Care to better define how states can address these challenges. The council, composed of state medical directors, Medicaid and long-term care leaders, and other officials, identified contributors to the current low uptake of these services across community and hospital settings. These include a lack of state policy infrastructure, limited public and provider awareness of palliative care benefits, stigma, and workforce capacity. 

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