The model aims to expand access to palliative care earlier in serious illness and declining health, helping patients receive support sooner and stay in their homes longer.
[WASHINGTON, D.C.] — The National Partnership for Healthcare and Hospice Innovation (NPHI) and the Coalition to Transform Advanced Care (C-TAC), publicly announced today their commitment to developing a federal fee-for-service community-based palliative care model aimed at expanding access to care across the United States.
This initiative builds on longstanding work across the field to expand access to palliative care, particularly as its use has grown in hospital settings over time. While that progress helped establish a strong foundation, access to community-based palliative care remains limited, and patients often encounter these services too late in their care journey. Gaps in consistent data and evidence have also made it more difficult to fully demonstrate the impact of earlier, community-based interventions. Through this partnership, NPHI and C-TAC are working to address these challenges by advancing a more sustainable, evidence-driven model for care delivery.
For decades, access to palliative care in the United States has remained limited, largely due to a lack of sustainable reimbursement pathways. This work and proposed model seek to address that gap by creating a more sustainable framework for delivering community-based palliative care earlier in the course of serious illness, rather than patients only receiving these services late in their care journey, often after entering hospice.
“This work builds on years of effort to expand access to high-quality care for patients with advanced illness,” said Tom Koutsoumpas, Founder and CEO of NPHI and Co-Founder & Co-Chair of C-TAC.“Patients should be able to access high-quality palliative care well before they need hospice services. For too long, this type of support has come too late in the care journey, despite providers delivering it for decades, often without sustainable reimbursement. Our focus is on supporting those providers while ensuring patients can access these services earlier, when they can have the greatest impact on quality of life and care outcomes.”
“Far too many patients and families navigate serious illness without the support that community-based palliative care can provide,” said Bill Novelli, Co-Founder & Co-Chair of C-TAC. “Partnerships like this are essential to moving the work forward, and we invite partners from across the health care system to come to the table to help expand access to whole-person, supportive care earlier in the care journey, not just at the end of life. By advancing a sustainable federal model for community-based palliative care, we can improve quality of life, better support caregivers, reduce unnecessary hospitalizations, and help more people remain where they most want to be — at home.”
NPHI and C-TAC will work together with federal leaders and many private sector stakeholders to establish a clear, consistent understanding of palliative care, identify the populations who would benefit most, and define how it can be effectively delivered in community settings within a sustainable reimbursement model.
“Nearly half of Medicare beneficiaries remain in Original Medicare, typically in a fee for service payment model,” said Cameron Muir, MD, Chief Medical & Innovation Officer at NPHI. “Given the costs associated with the highest needs beneficiaries (roughly 10% of Medicare patients are responsible for nearly 60% of Medicare expenditures), a community based palliative care model within fee for service Medicare is essential to support a sufficient “dose” of care. This model will bring about positive change toward supportive and preventive palliative care in the community setting keeping people where they’d rather be — at home.”
“To craft a plan that improves outcomes, reaches the right patients, and can be financially sustainable, C-TAC and NPHI will have the advantage of decades of clinical innovation and actuarial advancement,” said Kristofer Smith, MD, MPP, Senior Clinical Advisor, C-TAC. “We look forward to bringing those insights and partner voices to this important conversation and are excited to be at a moment when more can be done for the patients who need it most.”
NPHI and C-TAC look forward to continued collaboration with the Center for Medicare and Medicaid Innovation, and the many palliative care stakeholders who have been engaged in advancing this work over the past two decades.
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The National Partnership for Healthcare and Hospice Innovation (NPHI) is the leading organization representing nonprofit, community-based hospice and advanced illness care providers. Committed to excellence, NPHI’s members collaborate to ensure patients and families receive compassionate, high-quality care that respects their goals, values, and dignity. We help nonprofit providers thrive in an increasingly profit-driven healthcare landscape by advancing innovative, person-centered models and strengthening collaboration with leaders, policymakers, and healthcare partners nationwide. Learn more at nphihealth.org.
The Coalition to Transform Advanced Care (C-TAC) is dedicated to improving care and quality of life for people impacted by serious illness, particularly those who are underserved and under-resourced. We work alongside policymakers, regulators, advocates, health care leaders, and funders to advance equitable, person-centered policies that improve access to comprehensive care and support for patients, families, and unpaid caregivers. As a nonprofit, nonpartisan organization, C-TAC is recognized as a trusted, unbiased source of expertise on serious illness care and a respected convener of more than 190 member organizations committed to transforming the health care system to better honor the needs, goals, and dignity of every person. Learn more about our work and membership at TheCTAC.org
