NASHP Resource Hub: State Strategies to Address Palliative Care
Download this infographic as a slide deck.
Palliative Care Background
For individuals living with complex, often chronic conditions, and their families, palliative care can provide relief from symptoms, improve satisfaction and outcomes, and help address critical mental and spiritual needs during difficult times. Now more than ever, there is growing recognition of the importance of palliative care services for individuals with serious illness, such as advance care planning, pain and symptom management, care coordination, and team-based, multi-disciplinary support. These services can help patients and families cope with the symptoms and stressors of disease, better anticipate and avoid crises, and reduce unnecessary and/or unwanted care. While this model is grounded in evidence that demonstrates improved quality of life, better outcomes, and reduced cost for patients, only a fraction of individuals who could benefit from palliative care receive it.
To address this gap, NASHP convened a cross-agency group of state policy leaders to provide guidance in developing a framework for how states, as agents of change, can foster access to quality palliative care services. Recognizing that policy development is always driven by the varied goals and priorities of individual states, NASHP’s Seven Ways State Policymakers Can Promote Palliative Care offers a roadmap to help policymakers identify state-specific opportunities, areas of alignment, and ideas to aid future planning. Building on the roadmap, this toolkit provides additional concrete resources for states.
Framing the Message and Gathering Support
Palliative care is good care for people with serious illness. It can help avoid unnecessary and unwanted treatment, and prevent needless hospitalizations and other costly interventions. In spite of the well-documented benefits of palliative care, lack of familiarity, discomfort, and stigma can inhibit providers from offering palliative care and can prevent families and patients from asking for services that can support their individual goals and quality of life.
To bridge that gap, states can use public health messaging and other policy tools to promote understanding and greater acceptance of palliative care services. The National Academy for State Health Policy has identified a range of strategies and best practices that state leaders can deploy to promote palliative care among policymakers, patients and families, providers, the public, and other stakeholders:
Share information with policymakers. State leaders have noted in discussions that state policymakers themselves may not be fully familiar with palliative care, how it differs from hospice, and why states may have an interest in promoting these services and supports.
The infographic What States Need to Know About Palliative Care can provide policymakers with fast facts about palliative care, including why it is important for states and how states can improve access to high-quality palliative care.
State policymakers can share this tool with fellow officials and other stakeholders. The infographic can also be accessed as a slide deck that can be incorporated into Powerpoint presentations for easy use and dissemination. A factsheet developed by the Center to Advance Palliative Care may also be helpful in conveying what palliative can look like across a range of settings.
Provide information to the public: As a result of either state statutes or regulations, 13 states (view an interactive map showing their highlights) require agencies, such as state departments of public health, aging, or community health, to develop and disseminate resources about palliative care. These agencies share palliative care information with the public, individuals living with serious illnesses and their families, and health care providers. Content often includes information detailing how to access palliative care services, links to providers and programs, and continuing education opportunities for providers. Visit the websites of Nebraska and Texas to view informative, well-organized examples of state palliative care websites.
States that choose to create websites to educate the public may consider incorporating some of the following components:
- A comprehensive definition of palliative care;
- A list of hyperlinked state palliative care providers and services;
- Resources for patients and families: Some state websites provide patients and families with information about what palliative care is, how it can benefit both patients and families, and where palliative care services are provided across the state. States can include resources for patients and families such as:
- A “Is palliative care right for me” questionnaire;
- A link to Get Palliative Care;
- The one-pager: Centers for Medicare & Medicaid Services Palliative Care vs. Hospice Care;
- A link to Palliative Doctors, created by the American Academy of Hospice and Palliative Care Medicine;
- A link to geriatrics and extended care information provided by the Veterans Association; and
- Patient stories and testimonials.
- Resources tailored to non-palliative providers. States with comprehensive palliative care websites offer providers information about what palliative care entails, how it can help, and when providers should refer their patients to a palliative care specialist. Some states include the following resources for providers:
- Links to palliative care webinars;
- Links to continuing education opportunities; and
- Links to professional membership associations.
- States with a palliative care council may also consider including information about the council, its purpose, its agendas and minutes, any reports developed by the council, and its members on the state’s palliative care website.
Leverage contracting and regulation to promote awareness. Several states have statutes that require provider outreach or education about palliative care to patients who may benefit from these services. A few states have embedded these requirements into their regulatory language that enables oversight. New Jersey recently passed legislation requiring that hospitals, nursing homes, and rehabilitation and other facilities provide information about palliative care to patients with a serious illness or their families. Facilities not in compliance with the law may be required by the commissioner of health to develop an action plan to meet new requirements. In Wisconsin, the state’s Department of Health Services’ Division of Public Health contracts with Aging and Disability Resource Centers in the state to educate older adults and individuals with developmental or intellectual disabilities about palliative and hospice care.
Promote education about palliative care across a range of care settings. Massachusetts, New York, Oregon, and Rhode Island all require hospitals, nursing homes, and long-term care facilities to provide information to patients about palliative care. Oregon, for example, requires licensed health care facilities to have procedures in place to identify patients who could benefit from palliative care, provide education to patients, and facilitate referral to available services as needed. In Florida, health care providers – including primary care physicians and others – must share information and comply with requests for pain management or palliative care from patients.
Engage core partners. Over 25 states have taken legislative action to create a palliative care council or task force. Authorizing legislation across these states features common themes, such as composition of the overseeing body, frequency of meetings, and structural components. Councils and task forces, such as in Massachusetts, are often tasked with “the establishment, maintenance, operation, and evaluation of palliative care initiatives.” This may include conducting surveys to better understand the provision of palliative care services within a state (see Maine’s Palliative Care Survey), reporting on a state’s palliative care initiatives and capacity (see Tennessee’s 2019 Annual Report), or providing recommendations for the improvement of palliative care services (see Maryland’s Workgroup Recommendations). The composition and goals of these groups vary by state; for individual state task force information, view NASHP’s state palliative care task force interactive map.
Identify state champions and potential partners for this work. The Center to Advance Palliative Care (CAPC) publishes an annual report card that details available hospital-based palliative care programs in every state.
Coming soon from NASHP:
- How States Can Build Palliative Care Infrastructure and Promote Quality
- Enhancing the Sustainability and Value of Palliative Care through State Reimbursement Strategies
Palliative Care Across Settings
Download this Fact Sheet
Palliative care is specialized care for people living with a serious illness, focused on relieving 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 delivered by a team of professionals and should be available in all settings, especially acute care hospitals, clinical offices, post-acute and long-term care facilities, and patients’ homes. Regardless of setting, palliative care entails the following, consistent with the National Clinical Guidelines for Quality Palliative Care:
- Interdisciplinary team care delivered by certified specialists, including medicine, nursing, social work, and chaplaincy
- Comprehensive symptom and functional assessment
- Proactive pain and symptom management
- Effective communication that clarifies what to expect and supports decision-making that aligns with patient goals and values
- Relief of psychological, emotional, and spiritual suffering
- Ongoing family caregiver assessment and support
- Coordination among all clinicians involved in the patients’ care
Palliative care services can vary according to setting, based as factors such as which patient populations are primarily served and how the palliative care team interacts with the patient and with other clinicians. In addition, current payment models impact populations served and delivery models.
|Setting||Target Populations||Delivery Approach||Current Payment Models|
States with Palliative Care Advisory Councils or Task Forces
Many states have created a palliative care advisory council or other advisory groups through legislation and identified tasks the group should complete. The composition and goals of these groups vary by state; for individual state information, view or download NASHP’s chart below.
States with Palliative Care Information Campaigns
More than a dozen states across the country have passed legislation establishing education campaigns to promote palliative care among health care providers and the public. Their education efforts, featured on state public health websites, are designed to inform providers and consumers about palliative care for individuals with serious illnesses. The states’ websites provide an overview of palliative care, and often identify the advantages of palliative care delivery, options to access palliative care in the state, and links to resources. Download chart.
Building Infrastructure and Promoting Quality
In addition to promoting palliative care through education and public outreach, states can support access to and provision of palliative care through regulation, licensing, quality measurement initiatives, and support of services such as telehealth. States have multiple opportunities to build on existing infrastructures and initiatives to support the provision of palliative care services.
State legislators, regulators and licensors can all shape how palliative care services are delivered in hospitals, nursing facilities, and outpatient and in-home settings.
- State licensing and other regulations can define the types of palliative care services delivered, staff composition, training requirements, and other core features.
- States also oversee professional boards that determine minimum educational standards, continuing professional education requirements, and scope of practice.
Together, with other state strategies such as quality measurement and support for telehealth, these efforts can improve patient and provider understanding of palliative care, and encourage the delivery of high-quality services.
Define Palliative Care Services
One of the first steps leaders can take to promote access to palliative care is to make sure there is a clear definition of palliative care services. Defining palliative care services and standards can clarify the scope and purpose of palliative care and promote access to quality care across diverse settings. The resources below can be tapped by states interested in defining palliative care within their state’s health care system.
Include key features of the service: The National Consensus Project’s Clinical Practice Guidelines for Quality Palliative Care (4th edition), developed with input from experts and stakeholders, define palliative care as “an interdisciplinary care delivery system designed to anticipate, prevent, and manage physical, psychological, social, and spiritual suffering to optimize quality of life for patients, their families and caregivers. Palliative care can be delivered in any care setting through the collaboration of many types of care providers.” The guidelines emphasize core features of palliative care:
- Appropriate at any stage in a serious illness, and it is beneficial when provided along with treatments of curative or life-prolonging intent.
- Provided over time to patients based on their needs and not their prognosis.
- Offered in all care settings and by various organizations, such as physician practices, health systems, cancer centers, dialysis units, home health agencies, hospices, and long-term care providers.
- Focused on what is most important to the patient, family, and caregiver(s), assessing their goals and preferences and determining how best to achieve them.
- Interdisciplinary to attend to the holistic care needs of the patient and their identified family and caregivers.
California statute SB 1004 (Chapter 574, Statutes of 2014) require its Department of Health Care Services (DHCS) to establish standards for palliative care and provide technical assistance to managed care organizations contracting with the state Medicaid program, Medi-Cal.
California offered additional guidance in a 2018 All-Plan Letter from the Department of Health Care Services to Medi-Cal managed care plans. California required the following services in a minimum palliative care benefit, with further guidance for each service:
- Advance care planning;
- Palliative care assessment and consultation;
- Development of a plan of care;
- A palliative care team;
- Care coordination;
- Pain and symptom management; and
- Counseling and social services.
Distinguish Palliative Care from Hospice
Palliative care focuses on improving the quality of life for patients with serious illness, and can be offered at any point in care, alongside curative treatment. Hospice, a subset of palliative care, provides comfort care to patients with a terminal illness and their families, and is provided in the later stages of a disease, typically during the final 6 to 12 months. In many states, palliative care is defined exclusively within hospice regulation, which may reduce public understanding and access to these services. Texas highlighted the differences between the two services on their website on palliative care.
How Texas Defines Palliative Care and Hospice Services
|Texas: “Supportive palliative care (SPC) is patient and family-centered health care that optimizes quality of life for seriously ill patients (high-risk of mortality or life-limiting illness) and their families by:
SPC is provided without regard to patient age or terminal prognosis and does not require the patient to decline attempts at cure or other disease-modifying therapy.”
|Texas: “Hospice consists of a medically directed, interdisciplinary team-managed program of services that focuses on the patient and their family. Hospice is the gold standard method of caring for people at the stage of a terminal illness when no further curative or life-prolonging therapy is available or wished to be pursued by a patient or family member. Hospice services can assist the family (as well as family caregivers) in making the patient as comfortable as possible by optimizing pain and symptom management and other forms of physical and/or spiritual suffering as needed in a home or home-like setting.”|
Texas also developed this Comparison of Supportive Palliative Care vs. Hospice Care infographic to further distinguish between palliative care and hospice services.
Promote Access to Palliative Care across the Health Care Continuum
Palliative care can be delivered in different settings across the continuum of care, including inpatient settings, outpatient practices, clinics, and residential care facilities. States can use licensing and other policy approaches to support delivery of quality palliative care services in diverse settings:
Hospitals: In hospitals, palliative care may be delivered through a palliative care team that is available to consult with the treating team. Some larger hospitals may have palliative care units, where a palliative care team serves as the primary treating team. Maryland requires acute general hospitals and specialty chronic care hospitals with a minimum of 50 beds to provide a facility-wide palliative care program that provides consultation services. The regulation:
- Specifies that covered hospitals must promote palliative care and provide information to patients;
- Outlines staffing for palliative care programs, including designation of an interdisciplinary team and training to other hospital staff;
- Describes the palliative care services that must be offered; and
- Notes that staff, family, and patients shall have access to an ethics committee, among other requirements.
Long-term care facilities: Palliative care in long-term care facilities can be delivered through a team of social workers, medical and nursing staff, chaplains, and other professionals who provide visits and services. Organizations may contract with community-based palliative care teams to provide services.
States can develop regulations that shape what this care looks like in long-term care facilities. The following guidelines are from Colorado. While the state does not mandate that palliative care be offered, it has set standards for those facilities that choose to provide it.
Colorado’s palliative care standards (3.3.1) establish that “if palliative care is provided within a licensed health care entity, the licensee shall have written policies and procedures for the comprehensive delivery of these services. For each patient receiving palliative care, there shall be documentation in the plan of care defining evaluation of the patient and what services will be provided. The licensee’s policies and procedures shall address the following elements of palliative care and how they will be provided and documented:
(1) Assessment and management of the patient’s pain and other distressing symptoms;
(2) Goals of care and advance care planning;
(3) Provision of, or access to, services to meet the psychosocial and spiritual needs of the patient and family;
(4) Provision of, or access to, a support system to help the family cope during the patient’s illness, and
(5) As indicated, the need for bereavement support for families by providing resources or referral.”
Recent legislation in New Jersey establishes that licensed assisted living faculties, dementia care homes, nursing homes, assisted living residences, comprehensive personal care homes, residential health care facilities, hospitals, and long-term care facilities are required to have all administrative and professional medical staff complete annual training on advanced care planning, end-of-life care, and use of advance directives and Provider Orders for Life-Sustaining Treatment (POLST) forms.
Primary Care: Patient-centered medical homes (PCMH), an area of significant state investment, are enhanced primary care practices that offer team-based, coordinated care, often with integrated behavioral health capacity. PCMH practices may present opportunities for states to promote access to palliative care using existing team-based infrastructure. New York State used its Delivery System Reform Incentive Payment (DSRIP) to encourage palliative care access within PCMHs. As one of several health care transformation projects, performing provider systems (PPS) – local systems of care – were provided payment incentives to support PCMH practices to deliver palliative care. PPS that selected this project were required to achieve the following:
- “Identify appropriate primary care practices, preferably already using the PCMH model, who are willing to integrate Palliative Care into their practice model. If practices are not in the PCMH model, they will be expected to achieve at least Level 1 of the 2014 standards or most current PCMH Recognition Program standards within the first two years of the project. Provider systems may consider this as a service in a Medical Village in association with the primary care practice.
- Develop partnerships with community and provider resources including Hospice to bring the palliative care supports and services into the practice.
- Develop/adopt clinical guidelines agreed to by all partners including services and eligibility. This should include implementation, where appropriate, of the IPOS Staff, IPOS Patient, or IPOS Dem surveys. Engage staff in trainings to increase role–appropriate competence in palliative care skills.
- Engage with Medicaid Managed Care to address coverage of services.
- Develop a quality committee to monitor and address quality.”
Build Capacity to Provide Palliative Care
Provider discomfort, lack of knowledge, and limits on scope of practice can act as barriers to accessing palliative care. Through working with professional associations and other stakeholders, states can identify effective strategies to promote professional capacity in palliative care and increase access.
Utilize continuing education requirements: States can leverage continuing medical education (CME) requirements to build provider capacity in palliative care. States can pass legislation that mandates palliative care-related educational requirements for providers, or specify these requirements within medical board licensing and CME requirements. Currently four states explicitly mention “palliative care” or “palliative medicine” within the context of CME requirements: Georgia, New York, Rhode Island, and Vermont. Here are additional details about these states’ approaches:
|State||Palliative care-related CME information|
|Georgia||Georgia has legislation that requires physicians working in pain management clinics to have 20 hours of CME related to pain management or palliative medicine over two years, or be board-certified in pain management or palliative medicine. Documentation must be submitted every two years.
The Georgia Composite Medical Board requires physicians who prescribe Schedule II or III controlled substances for chronic pain for more than 50 percent of their annual patient population to fulfil this requirement.
|New York||New York State, within the context of controlled substances, passed legislation that requires licensed prescribers who have a DEA registration number to prescribe controlled substances to complete three hours of coursework on pain management, palliative care, and addiction, within a year of registration and then at least once every three years. As of 2020, three hours of coursework is hosted online through the University of Buffalo and sponsored by the New York State Department of Health.|
|Rhode Island||Rhode Island’s Board of Medical Licensure and Discipline requires physicians to complete at least four hours of CME on topics as determined by the director of the Rhode Island Department of Health. Current topics include opioid pain/chronic pain management and end of life/palliative care.|
|Vermont||Vermont’s Board of Medical Practice requires physicians completing CME requirements to complete at least one hour of continuing medical education on hospice, palliative care, or pain management services. Physicians must also take at least two hours on prescribing controlled substances.|
Provide training to providers: As part of its Medi-Cal palliative care initiative, California supported online palliative care training courses for qualified Medi-Cal providers through a contract with the California State University (CSU) Shiley Institute for Palliative Care.
Leverage telehealth: The current COVID-19 pandemic has highlighted the critical importance of telehealth in providing continuity of care to people with serious illness. Palliative services such as care coordination, social and psychological support, and advance planning are now being delivered through telehealth, allowing for the provision of palliative care services notwithstanding social distancing and access limitations in hard-hit hospitals. Key palliative care services can now be offered via telehealth, facilitated by increasing state and federal flexibilities:
- Pain and symptom management. Recent Drug Enforcement Agency guidance allows for qualified practitioners to be able to, during the declared public health emergency, prescribe controlled substances for medical purposes using specified audiovisual communication systems without having conducted an in-person evaluation, under specific circumstances and while complying with federal and state laws.
- Medicaid-related flexibilities that allow for remote provision of care. Within Medicaid, states can seek flexibility during emergencies using Section 1135 emergency waivers and Medicaid 1915 (c) Appendix K waivers, along with the ability to make modifications to state 1115 demonstration waivers, 1915(c) home and community-based services waivers, and Medicaid state plan amendments. The Centers for Medicare & Medicaid Services provides a 1135 waiver checklist to assist states; within the checklist, flexibilities that could support remote palliative care services include:
- Suspension of Medicaid fee-for-service prior authorization requirements
- Requiring fee-for-service providers to extend pre-existing authorizations through which a beneficiary has previously received prior authorization, through the termination of the emergency declaration
- Permitting providers located out-of-state or territory to provide care to an emergency state’s Medicaid enrollee and be reimbursed for that service.
- New York’s 1135 request included waiving prior authorization and medical necessity processes within fee-for-service programs and flexibilities on provision of care from out-of-state providers. New York State Department of Health released an FAQ document with guidance noting reimbursement for telephonic services to members where appropriate, supporting a policy that all Medicaid provider types are eligible for using forms of telehealth to provide services within their scope of practice when appropriate and possible during the emergency.
- Colorado, during the COVID-19 emergency, has temporarily added home health and hospice providers as eligible telehealth providers in their Medicaid program, with specifications about the type of telehealth that can be provided. Other updates regarding requirements, specific provisions and telehealth billing and reimbursement policy are hosted at Colorado.gov.
Review the state’s scope of practice regulations: California amended its hospice licensing statute to permit hospice providers to deliver palliative care to patients without a diagnosis of a terminal illness until Jan. 1, 2022 via a pilot program. Ohio’s HB 286 allows for the short-term provision of medically necessary palliative care services to non-hospice patients by hospice programs, in addition to requiring specified health care facilities and providers to develop a system to identify patients who could benefit from palliative care and provide them with information.
Identify quality measures and reporting strategies: States can monitor access to and quality of palliative care by requiring providers, accountable care organizations, and/or managed care plans to report on related metrics, or by including palliative care delivery in performance improvement projects. States may want to start by monitoring process metrics that correspond to specific palliative care services. States can consider information from existing national palliative care quality resources as a starting point. The National Quality Forum, the Center to Advance Palliative Care’s Serious Illness Strategies framework, and the Convening on Quality Measures for Serious Illness Care have developed robust resources that can help states define evidence-based standards of care and quality metrics.
Palliative care-related measures in long-term services and supports contracts. Colorado, Illinois, New York and Rhode Island included at least one palliative care-related quality metric, such as pain management or advance care planning, in their financial alignment demonstration or managed long-term services and supports (MLTSS) contracts. Performance on these metrics is often linked to financial incentives for managed care plans. Colorado, Illinois, and Rhode Island included the Healthcare Effectiveness Data and Information Set (HEDIS) Care for Older Adults measure, which measures the percentage of beneficiaries 66 years and older who had the following four services in one measurement year:
- Advance care planning;
- Medication review;
- Functional status assessment; and
- Pain assessment.
Palliative care-related measures within state quality improvement initiatives. New York State and Texas’s DSRIP programs incorporated palliative care metrics. New York’s program recently expired, but demonstrated improvement from Year 3 to Year 4 for the majority of palliative care quality measures on average. Texas’ program is in operation through 2022. Both states’ programs focused on transforming hospital care.
|Texas’ DSRIP program incentivizes hospitals and other providers to improve access to care and how care is delivered, targeting Medicaid enrollees and low-income uninsured individuals.
Palliative care measures include:
|New York’s DSRIP program is designed to further integrate palliative care into patient-centered medical home practices and nursing home settings. The project used Integrated Palliative Care Outcome Scale (IPOS), a standardized screening tool to identify which patients are most in need of palliative care interventions. They measured access to palliative care services for patients most in need, not the outcomes associated with palliative care interventions.
Quality measures included:
- NASHP quality measures webinar recording: In October 2019, NASHP hosted a webinar on quality measures, Utilizing Quality Measures to Build an Effective Palliative Care System, with information from New York State and the National Committee for Quality Assurance (NCQA).
- Example of guidelines: The National Consensus Project for Quality Palliative Care Clinical Practice Guidelines for Quality Palliative Care (4th edition)
- Example of guidance: California’s 2018 All-Plan Letter contains guidance and requirements about palliative care provision to Medi-Cal managed health plans.
- Accreditation: A range of settings can be certified in palliative care by the Joint Commission. Community Health Accreditation Partners (CHAP) also offers accreditation. States could consider working with publicly funded universities to develop accreditation programs for providers.
- Person-centered considerations: The Administration for Community Living (ACL) compiled a set of Person-Centered Principles for the Seriously Ill.
Training: The Centers to Advance Palliative Care (CAPC) created a document, The Case for Improving Communication and Symptom Management Skills, to support the idea that clinicians should be trained in communication and symptom management skills.
NASHP Palliative Care Resources
NASHP Webinar Recording: 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.
NASHP: 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.
Webinar: 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.
Health Affairs Blog: 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.
Webinar: 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
NASHP: 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.