The Serious Illness Quality Alignment Hub (“the Hub”) was a coordinated effort to develop a national strategic plan to incentivize the delivery of high-quality care for people living with a serious illness.

The Hub – led by CAPC, in collaboration with the National Quality Forum– was funded by the Gordon and Betty Moore Foundation. It completed four work streams:

Needs Assessment: investigating operations and opportunities across multiple levers of accountability

Accountability Committee: assessing and prioritizing opportunities to strengthen accountability, by feasibility and likely impact, across each of the levers

Quality Measurement Committee: cataloging measures and making recommendations to address measurement gaps

National Serious Illness Projects: coordinating and aligning multiple national efforts to improve standards and measures in the care of people living with serious illness

2.4.3 Serious Illness Quality Alignment Hub - QAH National Strategic Plan.png

What’s in the Toolkit

The Hub convenes more than thirty organizations to provide insight and feedback on strategies to improve the quality of care delivered to people with serious illness.


Empowering Americans 50 and older to choose how they live as they age.

Accountable Care Learning Collaborative (ACLC)

Accelerating the transition to accountable care by identifying the care delivery competencies needed for providers to succeed in risk-bearing payment models.

American Academy of Hospice and Palliative Medicine (AAHPM)

Advancing hospice and palliative medicine and palliative care physician leadership.

Blue Cross Blue Shield Massachusetts

Committed to providing access to high quality, affordable health care.

Blue Shield California

Dedicated to providing Californians with access to high-quality health care at an affordable price.

Catalyst for Payment Reform (CPR)

Committed to helping employers and other health care purchasers get better value for their health care dollar.

Centers for Medicare & Medicaid Services (CMS)

CMS's vision is that all beneficiaries have achieved their highest level of health, and disparities in health care quality and access have been eliminated.


Designing leading-edge health information technology and EHRs for the health care industry.

Coalition to Transform Advanced Care (CTAC)

Dedicated to the ideal that all Americans with advanced illness receive comprehensive, high-quality, person-and family-centered care.

Council of Medical Specialty Societies

Providing a forum for collaboration to influence policy, medical education and accreditation from a broad, cross-medical perspective.

Discern Health

Improving health and health care through quality-based payment and delivery models.

Duke-Margolis Center for Health Policy

Improving health and the value of health care through practical, innovative, and evidence-based policy solutions.


Hospitals use Epic software to manage the medical records of more than 64% of U.S. patients.

Icahn School of Medicine at Mount Sinai, Brookdale Department of Geriatrics and Palliative Medicine

Advancing the art and science of medical care through collaborative learning, social concern, and scholarly inquiry.

John D. Stoeckle Center for Primary Care Innovation

Revitalizing and redesigning the delivery of primary care.

Johns Hopkins University School of Medicine, Center on Aging and Health

Improving the health of the community and the world by setting the standard of excellence in medical education, research, and clinical care.

National Academy for State Health Policy (NASHP)

Forum of policymakers throughout state governments, learning, leading, and implementing innovative solutions to health policy challenges.

National Coalition for Hospice and Palliative Care

Home to the National Consensus Project for Quality Palliative Care, the Coalition was founded by the leading hospice and palliative care organizations to coordinate and collaborate on issues and activities of importance to the interdisciplinary hospice and palliative care field.

National Hospice & Palliative Care Organization (NHPCO)

Leading and mobilizing social change for improved care at the end of life.

National Patient Advocate Foundations (NPAF)

Promoting access to affordable, quality health care for people with chronic, debilitating, or life-threatening illnesses.

National Committee for Quality Assurance (NCQA)

Improving health care quality through the administration of evidence-based standards, measures, programs, and accreditation.

National Partnership for Women and Families

Using public education and advocacy to promote fairness in the workplace, quality health care, and policies that help women and men meet the dual demands of work and family.

National Quality Forum (NQF)

Leading national collaboration to improve health and healthcare quality through measurement.

Network for Regional Healthcare Improvement Organization (NRHI)

Improving health and healthcare in communities across the U.S. through an active and engaged network of Regional Health Improvement Collaboratives (RHICs).

Optum Supportive Care

Providing individuals and their families with access to specialized care with the goal of improving quality of life.

Oregon Health & Science University (OHSU)

Improving the health and quality of life for all Oregonians through excellence, innovation and leadership in health care, education and research.

Peterson Center on Healthcare

Dedicated to making higher quality, more affordable healthcare a reality for all Americans.

RAND Corporation

Developing solutions to public policy challenges to help make communities throughout the world safer and more secure, healthier and more prosperous.

The Joint Commission (TJC)

Committed to continuously improving health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value.

University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center

Advancing health worldwide through preeminent biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.

The Hub is coordinating twelve projects that contribute to a comprehensive system for promoting quality care and continuous improvement.

At-a-Glance Summary of Projects

Enumeration of each project, its goal, its organizational lead, and contact for more information.

National Consensus Project for Quality Palliative Care, 4th edition

The National Consensus Project (NCP) Clinical Practice Guidelines are the national standard for high quality palliative care. National Consensus Project for Quality Palliative Care, 2018.

Mapping Community Palliative Care

CAPC’s three-year national research project was the first nationwide scan of community palliative care programs.

Identifying Patients with Serious Illness: The Denominator Challenge

Using claims data to identify the population in need of palliative care. Kelley AS and Bollens-Lund E, Journal of Palliative Medicine, 2017.

Serious Illness Care Measures

National Committee for Quality Assurance (NCQA) recommended structure, assessment, and patient-reported measures for a serious illness program.

Measures of Care Experience for Seriously Ill Individuals

RAND Corporation is developing and testing new survey questions on the experience of care (similar to the CAHPS surveys) for people with serious illness and their families.

Advancing Quality & Transparency

The National Quality Forum convenes stakeholders to define best measures and next steps in quality improvement.

Advanced Alternative Payment Model

The American Academy of Hospice and Palliative Medicine (AAHPM) and the Coalition to Transform Advanced Care (C-TAC) are supporting the development of an alternative payment model (APM) for the care of Medicare beneficiaries with serious illness.

Purchaser Toolkit for High-Quality Serious Illness Care

Tools for employers and other stakeholders to specify required benefits and network competencies. Catalyst for Payment Reform and Center to Advance Palliative Care, 2018.

Improving Care for Patients With Serious Illness: Policy Recommendations from the Bipartisan Policy Center

Defining policy barriers to access and quality, and recommendations to overcome these barriers.

National Academy of State Health Policy (NASHP) Resource Hub: State Strategies to Address Palliative Care

Promising state policies and practices to advance access to quality palliative care.

Palliative Care Quality Collaborative (PCQC)

PCQC is a membership organization that operates a national unified palliative care registry, which captures both program and patient-level data. Membership allows palliative care teams to track their performance over time, benchmark against their peers, and participate in quality improvement offerings.

Tools and resources for various stakeholders to ensure high-quality, high-value care for people living with serious illness.

Serious Illness Quality Alignment Hub National Strategic Plan

Consolidation of selected areas of focus and defined strategies to enhance accountability for access to palliative care and enhance the quality of those services. Center to Advance Palliative Care and National Quality Forum, 2020.

Recommended Quality Measures

Measures that can be used by payers and policymakers to ensure quality care for people living with serious illness.

Serious Illness Quality Alignment Hub: 2019 Scorecard

Annual assessment of the status of palliative care access and quality assurance across the US.

National Quality Forum Issue Brief: Opportunities for Advancing Quality Measurement in Community-Based Serious Illness Care

Insights, recommended strategies, approaches, and tools, and a snapshot of the current quality measurement landscape for serious illness. National Quality Forum (NQF).

Accountability Systems Paradigm

Opportunities to improve access and quality across 10 "Accountability Systems" spanning federal, state, and private arenas.

The Serious Illness Quality Alignment Hub Scorecard 2018

Annual assessment of the status of quality assurance across the U.S.

Recommended Standards for Hospitals and SNFs

Structures and processes that all hospitals and skilled nursing facilities need to assure access to high-quality care for people with serious illness.

Purchaser Toolkit for High-Quality Serious Illness Care

Tools for employers and other stakeholders to specify required benefits and network competencies. Catalyst for Payment Reform and Center to Advance Palliative Care, 2018.

State Definition and Standards

Recommended palliative care definitions and standards used for state legislation.

State Issue Brief

How palliative care fills gaps in U.S. health care, and state-level policy recommendations to expand access to it.

Measurement of Function: Results from NQF Strategy Session

The Hub Quality Committee gathered in February 2019 to explore best practices and opportunities to improve measurement of function. National Quality Forum, 2019.

Publications guiding the work of the Hub.

A National Strategy For Palliative Care

Illustrates the gaps in care for people with serious illness, and the need for a national strategy to ensure reliable access to high-quality palliative care. Health Affairs, 2017.

Banff Convening Summary Report

2017 convening on accountability for access to quality care of people with serious illness in community settings.

Special Edition of the Journal of Palliative Care

March 2018 issue dedicated to quality measurement and accountability for community-based care for people living with serious illness.