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Fact Sheet | Legislative

Community-Based Palliative Care Demo

August 22, 2023

Community-Based Palliative Care Demo S. 2565

Palliative care is interdisciplinary patient and family-centered care that optimizes quality of life by anticipating, preventing, and treating suffering of all kinds. It is appropriate at any age and any stage in a serious illness, and involves addressing physical, intellectual, emotional, social, and spiritual needs. Despite the proven impact it has on patient and family wellbeing, and its ability to reduce health care spending associated with unnecessary acute care utilization, the lack of a predictable and sustainable payment mechanism has limited community-based palliative care’s development and reach across the country. As the population continues to age and people live longer with serious and chronic illnesses, innovative delivery and financing models are needed to increase access to community-based palliative care’s many benefits.

The Expanding Access to Palliative Care Act (S. 2565) would help address the need for new ways to support these kinds of models by directing the Center for Medicare and Medicaid Innovation (CMMI) to implement a community-based palliative care (CBPC) demonstration aimed at improving the quality of life and quality of care of people living with serious illness and their families. Informed by CMMI’s exisiting Medicare Care Choices Model (MCCM) that tests concurrent hospice-like services and curative treatments, the new CBPC model called for by S. 2565 would provide an extra layer of interdisciplinary support to some of the sickest and most vulnerable Medicare beneficiaries. As COVID-19 has demonstrated, there is a great unmet need for better and more comprehensive palliative pain and symptom management, care coordination, and caregiver support. The Expanding Access to Palliative Care Act can help increase access to these critical services by testing a novel way to pay and deliver for them under a value-based structure that benefits patients, families, and providers.

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