The Center to Advance Palliative Care (CAPC) announces the launch of the Serious Illness Quality Alignment Hub, an initiative to align the existing U.S. health system quality assurance mechanisms with the best practices in caring for patients facing serious illness. CAPC will lead the national effort in collaboration with the National Quality Forum (NQF). Financial support in the amount of $2.4 million will be provided by the Gordon and Betty Moore Foundation.

Serious illness carries a high risk of mortality and either negatively impacts a person’s quality of life or excessively strains their caregivers. Currently, millions of Americans are living with one or more serious illnesses, such as cancer, heart, lung, kidney, and neurological disease, and their ranks are expected to swell with the aging of our population. The care delivered to these patients varies dramatically across the country.

At the same time, there already exist a variety of mechanisms to hold providers accountable to evidence-based standards and the delivery of quality care. Building from this foundation, which has focused on prevention and cost-efficiency, the Hub will work to adapt those mechanisms to reflect the measures and practices that matter most to seriously ill patients and their families.

“While systems of accountability already exist, they do not yet adequately reflect what’s needed by people struggling with the burdens and stresses of serious illness,” notes Allison Silvers, MBA, co-director of the Serious Illness Quality Alignment Hub, along with Amy Kelley, MD. “We need to ensure there’s sufficient attention to well-being after an illness has occurred.”

The existing U.S. health care accountability systems are wide-ranging, and include:

  • Private employers (“purchasers”), which make decisions about the benefits to be included (or not included) in the health plans, provider networks and services offered to their employees.
  • Private health plans, which can offer incentives (i.e., financial bonuses and penalties) and establish requirements for their network providers (e.g., accreditation and/or certification programs).
  • The Centers for Medicare & Medicaid Services, which can impose specific requirements and incentives through Medicare’s conditions of participation, regulation, value-based purchasing programs and public reporting.
  • States, which oversee health plans, Medicaid and long-term care, and can spearhead targeted quality assurance initiatives.

The Serious Illness Quality Alignment Hub will work with key organizations across all the existing accountability systems to integrate a set of standards and measures into their requirements and incentive programs. Potential outcomes include:

  • Addition of a serious illness quality measure into Medicare accountable care organization quality benchmarks
  • Adoption by purchasers of model contract language specifying how a health plan must support their employees identified as seriously ill
  • Palliative care certification as a criterion used in health plan network credentialing
  • Home-based palliative care licensure created in certain states

“The ultimate goal of the Hub is to create meaningful change in organizational and clinician behavior, in order to ensure the best care for seriously ill patients. It is important that we engage and try to influence accountability systems early and consistently, before a cacophony of different, perhaps conflicting, standards and measures are promulgated. This would burden providers and let the needs of the most seriously ill patients slip through the cracks,” said Diane E. Meier, MD, director of CAPC.

“We have an obligation as a nation to ensure that the millions of Americans facing the challenge of serious illness have access to the high-quality care they need, where they seek it,” said Shantanu Agrawal, MD, MPhil, NQF’s president and CEO. “NQF is proud to work with CAPC to set standards of quality for serious illness care, and support providers in measuring and improving quality and outcomes at the frontlines of care.” NQF will lead the quality measurement work of the Hub.

Information about the Serious Illness Quality Alignment Hub can be found at

About CAPC
The Center to Advance Palliative Care (CAPC) is a national, member-based organization dedicated to increasing the availability of quality palliative care services for people facing serious illness. CAPC provides health care organizations with the tools, training, technical assistance and metrics needed to support the successful implementation and integration of palliative care. For more information, visit or find CAPC on Twitter, Facebook, and YouTube.

About NQF
The National Quality Forum leads national collaboration to improve health and health care quality through measurement. Learn more at

About Gordon and Betty Moore Foundation
The Gordon and Betty Moore Foundation fosters path-breaking scientific discovery, environmental conservation, patient care improvements and the preservation of the special character of the Bay Area. Learn more at

Lisa Morgan, LDM Strategies

[email protected]

Related Links:
The Banff Convening Report: Quality Measurement and Accountability for Community-Based Serious Illness Care

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