The Future of Palliative Care: Who Will Lead, Who Will Pay, and What Comes Next? | Part One

Palliative care isn’t struggling to prove that it works.  The bigger question now is whether our healthcare system can figure out how to deliver it to everyone who needs it—and sustainably pay for it.

In Part One, Chris Comeaux sits down with Brynn Bowman, CEO of the Center to Advance Palliative Care (CAPC), for a candid look at where palliative care is headed next.  Brynn paints a compelling picture of what success could look like five years from now: a patient living in rural America should have access to high-quality palliative care just as reliably as someone living near a major health system.  Getting there, however, will require more than simply creating more programs. It will take new partnerships, technology, education, stronger reimbursement, and a willingness to rethink how specialty palliative care fits into the larger serious-illness ecosystem. 

That leads to one of the most important questions in the conversation: If everyone begins offering pieces of palliative care, what actually makes it palliative care?  Brynn shares why CAPC is working to establish minimum standards for specialty palliative care—and why defining expectations around staffing, training, services, quality, and outcomes matters for both patients and payers.  Chris and Brynn also dig into the financial reality facing programs today, the gaps that still exist in rural and community-based care, and what recent activity from CMS could mean for the future of reimbursement. 

This isn’t simply a conversation about where palliative care has been.  It’s about who will define what it becomes next. For hospice and palliative care leaders, health systems, and organizations caring for people with serious illness, Part One raises important questions about how to expand access without diluting quality—and how to build a model that can endure.

Episode Highlights

• A five-year vision for palliative care: What would it take to make high-quality care available to patients regardless of where they live?
• The rise of “substitution competition”: How oncology, home health, Medicare Advantage, hospital-at-home, navigation companies, and other models are changing the serious-illness landscape. 
• What makes specialty palliative care different: Why expanding palliative care skills throughout healthcare doesn’t eliminate the need for expert specialty teams.
• Defining the standard before someone else does: Why CAPC is developing minimum standards for specialty palliative care programs.
• The reimbursement puzzle: Why many programs still have to “braid” together multiple revenue streams to make palliative care financially sustainable. 
• Closing the access gaps: How CAPC’s Palliative Care Program Inventory could provide a clearer picture of where care exists—and where it doesn’t.
• CMS is paying attention: Why recent activity across hospice, home health, and the physician fee schedule could represent an important opportunity for the field. 
• Clearing up the home health confusion: What the proposed home health rule actually says about palliative care—and what it does not.
  

If your organization provides hospice, palliative care, serious-illness care, or community-based healthcare, this is a conversation worth paying attention to.  The future of palliative care is taking shape now—and the decisions being made today could determine who gets access, what quality looks like, and how the care is ultimately funded.

Watch for Part Two of this episode coming this Friday.

Show Transcript

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