A bipartisan group of U.S. Senators has launched a new caucus to focus on legislation and policy that impacts palliative care. The legislators said they expect the Comprehensive Care Caucus to raise awareness of palliative care, promote utilization, improve care coordination, support caregivers and expand access to palliative care services.
Founding members of the Comprehensive Care Caucus include Sens. Jacky Rosen (D-Nev.), Tammy Baldwin (D-Wis.), Deb Fischer (R-Neb.) and John Barrasso (R-Wy.).
“As someone who stepped back from my career to take care of my parents and in-laws as they got older and started having serious health problems, I understand just how important it is for working families to have access to the medically advantageous and cost-saving benefits of palliative care,” Rosen said. “About one in eight people are living with a serious illness, and many of those patients lack access to comprehensive treatment that includes palliative care. We know that millions of Americans could benefit from access to palliative care, and by launching today’s bipartisan caucus, we will be able to give this very real issue the attention that it deserves.”
Among other initiatives, the caucus will likely focus on passage of legislation such as the Provider Training in Palliative Care Act, the Palliative Care and Hospice Education and Training Act (PCHETA) and the Rural Access to Hospice Act.
These pieces of legislation, respectively, would make palliative care clinicians eligible to participate in the National Health Service Corps, provide funds for clinician education and public awareness, and allow physicians in Rural Health Centers and Federal Qualified Health Centers to serve as attending physicians for patients in hospice.
“We have seen a proliferation of palliative care and palliative care-relevant legislation in recent years, which is really exciting. A lot of really promising bills have been introduce, and a primary goal of the caucus will be bringing new attention to palliative care and move these pieces of legislation forward,” Stacie Sinclair, senior policy manager for the Center to Advance Palliative Care told Hospice News. “I am encouraged by the bipartisan leadership of the caucus. We know that serious illness knows no party lines, and the caucus has the potential to educate other members of Congress on palliative care and elevate its profile.”
Rosen had worked to establish a similar caucus during her tenure in the House of Representatives, an effort she renewed after transitioning to the Senate.
Lack of awareness is a major barrier to palliative care expansion. A Journal of Palliative Medicine study, published in April, found that as many as 71% of people in the United States have little to no understanding of what palliative care is, including many clinicians in a position to refer patients to palliative care or hospice.
Close to 60% of patients who would benefit from palliative care do not receive those services, despite the availability of community-based palliative care as well as hospital-based palliative care, according to a recent report from the New England Journal of Medicine Catalyst Insights Council.
Expansion of palliative care could also help bring patients under the wings of hospice earlier in the progression of their illnesses.
“Sometimes we see palliative care fill in a gap in care and services that people need further upstream from hospice care, and often when that care is received and done well we see that people get transitioned to hospice in a more timely manner,” said Lori Bishop, vice president of palliative and advanced care for the National Hospice & Palliative Care Organization. “When we don’t have that relationship to hospice sometimes we see people either in hospice for too long or in hospice for a time that is too short. Lengths of state of less than seven days are not unusual for 30% of the hospice population served.”
Hospice organizations also hope that the caucus will address the lack of standardization in palliative care services as well as build a regulatory framework that could support the development of Medicare reimbursement models for palliative care, Bishop told Hospice News.
Sen. Barrasso said that his experience as a physician gives him a unique perspective on palliative care and will help fuel his work with the caucus.
“For more than two decades, I had the privilege of practicing medicine in Wyoming. Helping patients and their families face difficult health care situations made me appreciate the importance of palliative care,” Bassarro told Hospice News. “This is why I’m proud to help lead the Comprehensive Care Caucus to improve the quality of life for patients and their dedicated caregivers.”