Pew, Health Groups Offer Policy Recommendations for End-of-Life Care

This page was updated June 19, 2017, with a list of organizations endorsing the recommendations in this letter.

The Pew Charitable Trusts and leading health organizations urged the Trump administration on Tuesday, February 21^st to take steps to improve care for the millions of Americans who are living with a serious or terminal illness.

Ensuring that the health care system is able to deliver high-quality palliative and end-of-life care has become increasingly vital as the proportion of elderly Americans grows. Within the next two decades, 1 in 5 Americans will be older than 65. Reforming how the health care system takes care of people with a serious illness could also reduce health care expenditures. About 5 percent of the population is responsible for over half of the nation’s health care spending. Much of that spending conflicts with a patient’s values or preferences.

Based on extensive research and the experience of private sector clinicians and health plans, the group recommended that policies be put in place to:

• Improve the workforce that cares for patients near the end of their lives, through increased education and training.
• Promote measures that reinforce delivery of high-quality end-of-life care.
• Expand payment and care models to test innovative methods to provide this care.
• Support additional research to find ways to improve the quality of palliative and end-of-life care.
• Ensure that patients’ preferences for end-of-life care are clearly recorded in electronic health records that are accessible to caregivers.

The concepts underlying these recommendations are not new. Lawmakers from both parties supported bills in the last Congress to address these issues, including the Palliative Care and Hospice Education and Training Act, the Care Planning Act, the Personalize Your Care Act 2.0, and the Compassionate Care Act. The organizations urged the administration to work with Congress to enact such measures, which would improve the quality of life and care for millions of people with a serious illness and their families, and improve the overall sustainability of the health care system.

Participating organizations include:

• American Academy of Hospice and Palliative Medicine.
• American Cancer Society Cancer Action Network.
• American Geriatrics Society.
• American Heart Association/American Stroke Association.
• Blue Shield of California.
• Cambia Health Solutions.
• Center to Advance Palliative Care.
• Coalition to Transform Advanced Care.
• Consumer Coalition for Quality Health Care.
• National Coalition for Hospice and Palliative Care.
• National Hospice and Palliative Care Organization.
• National POLST Paradigm.
• The Pew Charitable Trusts.

 Endorsements: 

• Alzheimer's Association
• AMDA: The Society on Post-Acute and Long-Term Care
• Aspire Health
• Association of Professional Chaplains
• Blue Cross Blue Shield of Massachusetts
• Coalition for Compassionate Care of California
• Compassus
• HealthCare Chaplaincy Network
• Hospice and Palliative Nurses Association
• National Palliative Care Research Center
• National Partnership for Women and Families
• Social Work Hospice and Palliative Care Network
• St. Mary Medical Center
• The California State University Institute for Palliative Care
• The Gary and Mary West Health Institute
• The George Washington University's Institute for Spirituality and Health
• The National Coalition on Care Coordination
• The Oncology Nursing Society
• Trinity Health