How States Can Expand Access To Palliative Care

Access to palliative care for people with serious illness, i.e., those with serious medical conditions, functional impairment, and high health care utilization, has expanded greatly over the last decade due to a rapidly increasing aging population with complex and costly care needs; a growing evidence base demonstrating that palliative care improves patient and caregiver quality of life and reduces overall cost; and an accelerated transition to payment models that reward value over volume.

As the new administration strategizes how to repeal and replace the Affordable Care Act (ACA)—and how to shift risk and responsibility for health care payment to states, health care organizations, commercial payers, providers, and patients and families themselves—we expect state policy to play a more dominant role in determining who gets care, how it is paid for, and how to set and achieve a standard of quality and safety. Of great concern is the impact of a potentially destabilized insurance market that could lead to loss of coverage for people with the greatest need for health care services, such as those with serious illness. Outcomes for this group are especially important as a majority of the seriously ill fall into the top 5 percent of the population that accounts for 50 percent of total health care expenditures.

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