Frequently Asked Questions

What is palliative care?

Palliative care (pronounced pal-lee-uh-tiv) is specialized medical care for people with serious illnesses. It is focused on providing patients with relief from the symptoms, pain, and stresses of a serious illness—whatever the diagnosis. The goal is to improve quality of life for both the patient and the family.

Palliative care is provided by a team of doctors, nurses, and other specialists who work together with a patient's other doctors to provide an extra layer of support. It is appropriate at any age and at any stage in a serious illness and can be provided along with curative treatment.

Who requires palliative care?

Palliative care is appropriate for anyone suffering a serious, chronic or life-threatening illness (e.g., cancer, cardiac disease, respiratory disease, kidney failure, Alzheimer′s, AIDS, amyotrophic lateral sclerosis (ALS) and more). You can receive palliative care at any age at any stage of an illness.

How do you pay for palliative care?

Palliative care is treated in the same way as medical services (e.g. cardiology). Most insurance plans, including Medicare and Medicaid, cover all or part of palliative care.

How do you get palliative care?

Palliative care is primarily provided in the hospital where patients can ask their doctor for a referral to the palliative care team. The team is composed of palliative care doctors, nurses and social workers. Depending on the hospital, teams may also include other disciplines such as pharmacy.

Do patients have to give up their own doctor?

No. Palliative care teams are consultants and work along with the primary doctor.

Why a state-by-state report card?

The goal of the state-by-state report card is to determine whether seriously ill patients throughout the United States are receiving equitable care.

This issue is critical. There are approximately 90 million Americans living with serious and life-threatening illness, and this number is expected to more than double over the next 25 years with the aging of the baby boomers. Most seriously ill people will spend time in the hospital over the course of their illness.

What does the report card measure?

The report card measures the extent to which seriously ill patients and their families have access to palliative care teams in hospitals. Specifically, it examines variations at the state and district levels in order to assess whether people facing seriously illness throughout the United States are receiving equitable care. Specifically, the report card examines:

1. Patient access to palliative care services in hospitals
2. Patient access to board-certified palliative medicine physicians

Grades are based upon the percentage, per individual state, of palliative care teams in hospitals with 50 or more beds. Hospitals with 50 or more beds are the primary focus of the report card since smaller hospitals than this are unlikely to be able to support a full interdisciplinary palliative care team.

This national and state-by-state report presents the most accurate estimates to date of the prevalence of hospital palliative care programs in the United States.

Who conducted the study?

The study was conducted by the Center to Advance Palliative Care (CAPC) and the National Palliative Care Research Center (NPCRC).  The research team was led by R. Sean Morrison, MD, director of the National Palliative Care Research Center. Data was obtained from the AHA Annual Survey Database™ for fiscal year 2009 and the National Palliative Care Registry™.

Can the report card be found online?

Yes. The report card Web site can be found at www.capc.org/reportcard and www.getpalliativecare.org . You will also be able to access it directly from the home page of both Web sites.

Where else will the study be published?

The key findings from the study will be published in the October 2011 issue of Journal of Palliative Medicine. The entire report can be found at www.capc.org/reportcard .

My state did not get a good grade, how can we improve?

Encourage hospitals within your state that do not have a palliative care team to implement one. Visit www.capc.org for help with tools, training and technical assistance.

See Recommendations

Does palliative care have an impact on hospital and healthcare spending?

Palliative care teams provide an organized, highly structured system for delivering care in the hospital. By delivering highly-effective, rigorously coordinated care, palliative care teams have a direct impact on cost reduction through:

• Decreased ICU stays and pharmacy costs
• Decreased hospital costs through decreased lengths of stay and unnecessary tests
• Efficiently coordinated care transitions

What are the implications for Medicare and Medicaid?

The patient population driving runaway medical spending is the target population for palliative care:

• The seriously ill constitute only 5-10% of patients, but account for more than half of the nation's total healthcare costs.
• The 10% of Medicare beneficiaries with 5 or more co-morbid illnesses account for two-thirds of total Medicare spending.
• The 4% of the sickest Medicaid beneficiaries account for fully 48% of total program spending; 76% of the national Medicaid budget goes to acute hospital services, the most expensive setting of care.