State Palliative Care Recommendations and Resources
Supporting People with Serious Illness During the Pandemic: The Growing Need for Palliative Care, June 30, 2020. The value of supporting individuals with serious illness through care management and planning, behavioral and physical symptom relief, and other added supports has been evident during the COVID-19 pandemic. Policymakers are now grappling with how to restructure hard-hit health care systems to better support individuals with serious and complex needs. As state budgets shrink, palliative care may be an important part of the answer. With funding from The John A. Hartford Foundation, NASHP hosted a webinar to discuss state policies and recommendations to support the future of palliative care.
State Strategies to Expand Access to Palliative Care, March 16, 2020. State policymakers are uniquely positioned to impact access, quality, and costs of care for high-need, high-cost populations. Palliative care has been shown to help individuals with serious illness better manage the symptoms and stressors of disease – improving care and reducing cost. With funding from The John A. Hartford Foundation, this webinar features state leaders from Arizona who discuss their policies, payment, and innovations to support palliative care.
Health Affairs Grantwatch: States Take Up Palliative Care: NASHP’s Work with the John A. Hartford Foundation, Nov. 20, 2019. In this Health Affairs blog, NASHP, which researched palliative care initiatives in all 50 states, features recommendations to help states advance their palliative care policies. It highlights how, with support from the foundation, NASHP is now building a series of state policy tools and resources derived from state implementers.
Seven Ways State Policymakers Can Promote Palliative Care, November 2019. States face challenges as they work to integrate palliative care across the health care continuum. This seven-step roadmap offers strategies that policymakers can use to implement and improve palliative care services in their states.
Utilizing Quality Measures to Build an Effective Palliative Care System, October 2019. This NASHP webinar provided an overview of the landscape of palliative care quality measurement, how quality measures can be utilized, and highlighted information from New York State and the National Committee for Quality Assurance to improve tracking and reporting on quality palliative care measures.
States Chart a Policy Path to Improve Palliative Care Services Across the Care Continuum, Aug. 13, 2019. In this Health Affairs Blog, NASHP highlights how It convened the State Leadership Council on Palliative Care, with support from The John A. Hartford Foundation, and is using the council’s policy recommendations to better define how states can increase access and improve the quality of palliative care.
Palliative Care: A Primer for State Policymakers, May 2019. This new National Academy for State Health Policy primer, with funding from The John A. Hartford Foundation, identifies policy approaches states can use to implement and expand palliative care in their states.
Advancing Palliative Care for Adults with Serious Illness: A National Review of State Palliative Care Policies and Programs, January 2019. In September 2018, NASHP conducted a comprehensive scan of how states are supporting the delivery of palliative care to adults. This webinar highlighted major trends from all 50 states and Washington, DC, promising policy approaches, and key considerations for states identified through the scan. Additionally, it featured a presentation on how Texas is working to advance palliative care through stakeholder engagement and Medicaid quality improvement initiatives.
Advancing Palliative Care for Adults with Serious Illness: A National Review of State Palliative Care Policies and Programs, December 2018. NASHP conducted a comprehensive review of how states are supporting the delivery of palliative care to adults. This comprehensive report, and accompanying charts, highlights major trends observed from all 50 states and Washington, DC, promising policy approaches, and key considerations for states to enhance palliative care access and quality across settings.
- Read or download the report: Advancing Palliative Care for Adults with Serious Illness: A National Review of State Palliative Care Policies and Programs
- Read or download Appendix A: Scan of State Regulations for Adult Palliative Care Activity
- Read or download Appendix B: Scan of State Medicaid Programs for Adult Palliative Care
States Explore Strategies to Advance Palliative Care at #NASHPCONF18, September 2018. In August, 2018, a group of state policymakers gathered at NASHP’s annual health policy conference to explore how to advance palliative care services in states. This blog explores what steps California, Colorado, Maryland, and Rhode Island have taken to advance palliative care through Medicaid reimbursement, regulatory updates, workforce development, and stakeholder engagement.
Jason McGill, Assistant Director, Washington Medicaid Programs Division, Washington State Health Authority
As our governor has said about palliative care, it’s important that we have choice and dignity. Palliative care provides people with choice and dignity. Of course, not just for end-of-life hospice care, but also for care for people living with serious illness to help them feel comfortable whether it be in their homes or elsewhere. In Washington, we’re working hard to consider these issues in tandem.
We have recently led a major effort through the Bree Collaborative, our state’s statutory cross-sectional task force, to help solve vexing problems in health care. The recommendations are comprehensive and far-reaching. The report states: “Provision of palliative care consistently shows improved outcomes for patients in both in- and outpatient settings. However, many patients who would benefit from palliative care do not receive this service. Access issues stemming from lack of workforce, lack of referrals, and lack of a sustainable business model contribute to low utilization rates.”
The workgroup developed the following focus areas to increase accessibility and quality of palliative care:
- Defining palliative care using the standard definition developed by the National Consensus Project, including appropriateness of primary and specialty palliative care.
- Spreading awareness of palliative care.
- Clinical best practice provision of palliative that is:
- Responsive to local cultural needs;
- Includes advance care planning as outlined in the 2014 Bree Collaborative End-of-Life Care Report and Recommendations including appropriateness of an advance directive and Physician Orders for Life-Sustaining Treatment (POLST) or similar suitable document; and
- Incorporates goals of care conversations into the medical record and plan of care.
- Availability of palliative care through revision of benefit structure such as a per participant per month (PPPM) benefit.