State policymakers increasingly recognize the value of palliative care—not only to the local health care delivery system and state Medicaid programs, but also to employers and families. Palliative care is one of the few solutions that simultaneously improves care quality, reduces burden on family caregivers, and results in more cost-effective use of resources.

Some states have spearheaded policy initiatives to increase access to palliative care, but more needs to be done.

Use this toolkit to learn the issues and opportunities, explore recent state initiatives, and access guidance on implementation. If you are developing or have completed a successful state policy initiative related to palliative care and would like to share your work with other states, please contact paymentandpolicy@capc.org.

What’s in the Toolkit

Learn how states can be powerful drivers of policies that expand access to palliative care and which opportunities and gaps exist in your state.

State Issue Brief

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

Evidence Base

Key publications on palliative care's impact on quality and costs.

How States Can Expand Access to Palliative Care

Health Affairs blog identifying state levers to expand palliative care access - and how to get started.

2019 State-by-State Report Card

2019 report on growth of hospital palliative care across the fifty states, gaps in access, and federal and state policy recommendations.

Individual State Palliative Care Reports

View your state’s report to find information about palliative care access in your state, along with recommendations to improve it.

Regulatory and Licensure Considerations
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Legal obstacles impeding access to palliative care.

Formulate a state policy strategy and find palliative care providers in your state.

State Advisory Council Legislation Tracking

Status tracker for state Palliative Care Advisory Councils or similar bodies. Includes relevant bills, statutes, and associated websites when available.

Advisory Council Suggestions for Getting Started

Suggested activities for newly established state palliative care advisory councils.

Palliative in Practice – Getting Started with State Coalitions and Associations

Blog post with considerations for state policy to improve care for patients with serious illness.

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.

Reframing Palliative Care: Messages Matter

Presentation on key messaging considerations for palliative care professional and advocates.

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.

Get Palliative Care Provider Directory

Searchable directory of specialty palliative care providers, filtered by care setting.

Mapping Community Palliative Care

Initiative to develop a comprehensive inventory of community-based palliative care programs across the country.

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.

Reflections from a Palliative Care Champion – California’s Kate O’Malley

Blog post on one state's experience with state payment policy for palliative care.

Reference existing state palliative care policy activities to inform your strategy.

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

Promising state policies and practices to advance palliative care.

Delivering Palliative Care to Medicaid Patients in California

Providing palliative care to Medicaid beneficiaries requires innovative program design strategies. See how providers, payers, and policy leaders in California are adopting these strategies.

State-Level Interventions to Expand Access to Palliative Care

State palliative care policies, initiatives, and lessons learned from California, Colorado, and South Carolina. CAPC National Seminar Presentation, 2017.

Guidance from other organizations working at the state level to improve care for people with serious illness.

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

Promising policies and practices states can use to advance access to quality palliative care for state residents living with serious illness. National Academy for State Health Policy (NASHP).

Palliative Care: A Primer for State Policymakers

Outline of field-tested definitions and resources, key policy considerations, and opportunities for states to support palliative care policies and programs. National Academy for State Health Policy (NASHP).

American Cancer Society Cancer Action Network (ACS CAN) Palliative Care Resources

Tools to promote policies that improve cancer care, including an annual report tracking individual state progress on adopting model palliative care legislation and other legislative priorities.

California Health Care Foundation (CHCF) Serious Illness & End-of-Life Care Topic Page

CHCF policy initiatives and programming to increase access to palliative care in CA.

Center for Improving Value in Health Care (CIVHC) Palliative Care Topic Page

Landscape assessment and policy recommendations to increase access to palliative care in Colorado.

Massachusetts Coalition for Serious Illness Care

A coalition of providers, payers, and policymakers working to improve the care of people with serious illness in Massachusetts.

Physician Orders for Life-Sustaining Treatment (POLST)

Order set that guides providers based on patients' advance care planning decisions.