Palliative care is specialized medical care for people living with a serious illness. This type of care 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.

Palliative care is provided by a specially-trained team of doctors, nurses, social workers, chaplains, and other specialists who work together with a patient’s other doctors to provide an extra layer of support. Palliative care is based on the needs of the patient, not on the patient’s prognosis. It is appropriate at any age and at any stage in a serious illness, and it can be provided along with curative treatment.

Learn more about palliative care and access the Palliative Care Provider Directory at GetPalliativeCare.org.

Palliative care is appropriate for anyone living with a serious illness (e.g., cancer, heart disease, dementia and other neurological conditions, kidney disease, and more), at any age or disease stage. It focuses on treating the symptoms and stress of the illness. The goal is to improve quality of life.

Palliative care is treated in the same way as other medical services (e.g., cardiology), where the physician or advanced practice provider bills insurance for the services they provide. Most insurance plans, including Medicare and Medicaid, cover all or part of palliative care. In addition, some palliative care programs contract with health plans for alternative payment arrangements, and this provides flexibility to deploy the interprofessional team members as needed to match needs.

Palliative care is provided in hospitals and often in outpatient clinics or in patients’ homes. Patients may either be referred to the palliative care team by their doctor, or may ask their doctor for a referral to see the palliative care team. You can find palliative care programs near you through CAPC’s GetPalliativeCare.org Palliative Care Provider Directory.

No. Palliative care teams are consultants and work together with a person’s primary doctor.

There is a strong and growing evidence base demonstrating that palliative care improves quality of life and reduces symptom burden for patients living with serious illness, and their family/caregivers. Palliative care also increases patient satisfaction. And, as a result of proactive symptom management and improved care quality, palliative care can reduce avoidable spending and utilization in all settings. Visit CAPC’s website for more information. Some studies have found direct cost savings as much as $12,000 per patient.

The State-by-State Report Card on Access to Palliative Care in Our Nation’s Hospitals was a collaboration between the Center to Advance Palliative Care (CAPC) and the National Palliative Care Research Center (NPCRC), which produced four editions between 2006 to 2019. These reports measured the extent to which seriously ill patients and their families had access to palliative care teams in hospitals. Grades were based upon the percentage, per individual state, of hospitals with fifty or more beds that had palliative care teams.

As the field of palliative care has grown (including a significant increase in community-based palliative care, as well as the vast majority of large hospitals reporting a palliative care program), there is a need for greater specificity about palliative care access and capacity at the state levels. Furthermore, a broader picture of the serious illness landscape can help support champions’ efforts to expand palliative care access. The updated individual state reports provide more granular information on palliative care availability and infrastructure in each state, while the revised national report provides comparative information on palliative care capabilities across states. This gives palliative care champions more resources to identify and implement appropriate initiatives to improve palliative care access in their respective states.

State ratings are calculated using data from five domains: 1) specialty palliative care availability; 2) payment for palliative care services; 3) the presence of structured palliative care champion entities; 4) clinical skill building beyond specialty palliative care; and 5) foundational supports for families and caregivers (please see the Methodology and Sources page for more information). Strategies to improve your state’s rating can include (but are not limited to):

• Implementing palliative care programs in hospitals within your state that do not yet have one
• Exploring legislation to support the specialty palliative care workforce or advance palliative care payment in your state
• Establishing a palliative care advisory council or serious illness coalition to advance palliative care awareness and access in your state

Please see your individual State Report and/or the Recommendations for more detailed strategies.

The Serious Illness Scorecard and your individual state report are tools to raise awareness about gaps in palliative care capacity in your state, and to improve palliative care access locally and nationally. At the state level, use your star rating (i.e., how your state compares to others across the country) to increase state recognition and support for palliative care. Actions can include:

• Partnering with local organizations that focus on improving care for people living with a serious illness to promote Scorecard and individual state report dissemination
• Incorporating the Scorecard and your individual state report into meetings with state policymakers (e.g., legislators, State Medicaid Directors) to frame the need for palliative care access in your state
• Identifying state-specific palliative care gaps and opportunities, implementing relevant recommendations from the Scorecard and individual state report policy sections
• Incorporating Scorecard and individual state report findings into State Palliative Care Advisory Council (or similar body) deliberations, and leveraging the findings and policy recommendations to support the agenda

You can drive federal support for palliative care (particularly in support of passing the Palliative Care and Hospice Education and Training Act (PCHETA, S. 2243 in the 118th Congress) by meeting with your legislator to share the need for palliative care, highlight the gaps in the workforce, and share how PCHETA can help.

To learn more about state and federal opportunities to expand palliative care access, please visit:

• CAPC’s Policy Matters page
• National Academy for State Health Policy’s (NASHP) Palliative Care Resource Center
• Patient Quality of Life Coalition’s (PQLC) Advocacy page
• National Coalition for Hospice and Palliative Care’s (NCHPC) Advocacy page