There are 19,920 clinicians (across all disciplines) in the U.S. who hold specialty certification in hospice and palliative care. For prescribers (physicians, advanced practice nurses, and physician associates), this translates to 2.86 prescribers per 100,000 population nationwide, far below most other medical specialties. This is not nearly enough to meet estimated demand. Policymakers and provider organizations are innovating to meet demand.

Already, 13 states have legislation requiring payment for palliative care services. This includes specific Medicaid benefits for interdisciplinary community-based palliative care, mandates to Medicaid managed care organizations, and requirements for commercial insurers. In some other states, the largest commercial insurers offer palliative care programs, making a measurable difference in outcomes.

22 states include continuing education on pain management, palliative care, geriatrics, dementia/Alzheimer’s, and/or end-of-life care in their physician and/or nurse licensure requirements. In other states, medical and nursing boards may have incorporated palliative care content into their opioid training standards. Further, through CAPC’s clinical education, more than 136,000 doctors, nurses, social workers, case managers, and others have completed courses in communication skills, pain management and safe opioid prescribing, non-pain symptom management, best practice dementia care, and other essential palliative care skills.

Not only are Black Americans at the highest risk of mortality for illnesses such as cancer and heart disease, they are also less likely to receive appropriate pain and symptom management. People dually eligible for both Medicare and Medicaid face more than double the rate of mortality than Medicare-only beneficiaries, while at least 10% are living with a serious illness.