As the palliative care field continues to grow and transform, understanding the current trends, outlook, relevant challenges and necessary skills for future leaders is critical.

Two significant trends impacting the field of palliative care currently, according to experts, are the expansion of services and the integration of technology, particularly artificial intelligence (AI).

Dr. Vicki Jackson, board president of the American Academy of Hospice and Palliative Medicine (AAHPM), noted that palliative care has demonstrated a positive impact on patient-reported outcomes across various illnesses, including cancer, heart, liver, kidney disease and dementia.

“There is an increasing recognition of the importance of early integration of palliative care in the treatment process, leading to a broader range of services for patients with serious illnesses,” Jackson told Palliative Care News in an email.

She added that these services are now being offered in diverse settings, including outpatient and home-based care models.

While inpatient care continues to grow within this field, the expansion of home-based care is one of the most significant trends taking shape in palliative care, according to Dr. Gary Buckholz, clinical professor and palliative physician at the University of California (UC) San Diego Health.  

“[Home-based care] has caught the attention of payers who are trying to do value-based care and really taking on home-based palliative care as an opportunity to do that better for their patient population,” Buckholz told Palliative Care News. 

However, Buckholz also emphasized the challenge of deploying skilled professionals to the home-based arena, where he said the best providers typically have combined skills in primary care, palliative care and even geriatrics. 

“We need to be really thoughtful about how we work with primary care providers and utilize palliative care experts to better train and inform our primary care providers,” he said.

In addition to being named a 2024 Top Leader in Hospice and Palliative Care by AAHPM, Buckholz is co-director of the Sanford Compassionate Communication Fellowship at UC San Diego. 

Dr. Janet Abrahm, the creator of the first palliative care service and fellowship at the Dana-Farber Cancer Institute and Brigham and Women’s Hospital, said that with increased home care services, professionals can start meeting patients where they are. 

“There are already insurance companies that are supporting palliative home care teams, usually run by nurse practitioners mentored by board-certified physicians, and we need to be able to scale to areas that have very few palliative care providers,” Abrahm said.

The integration of technology into palliative care services and research is also on the rise, according to experts.

“In the palliative care research space, there has been a meteoric rise in AI-assisted ascertainment of quality of palliative care service delivery,“ Dr. Prasanna Ananth, associate professor of pediatrics at the Yale School of Medicine, told Palliative Care News in an email. “I imagine that, within the next decade, we will be using AI tools at various junctures of clinical care as a means to optimize symptom management and communication.”

Ananth was also named an Emerging Leader in Hospice and Palliative Care this year by AAHPM.

Abrahm cited the consolidation of health systems as another recent trend and noted how value-based programs from the U.S. Centers for Medicare & Medicaid Services (CMS) is affecting the palliative care space.

“We obviously don’t make money by our consultations like an ophthalmologist does, but we do a lot of cost avoidance and a lot of ability to help people make the right decision so that unnecessary expenditures are avoided,” Abrahm said.

Despite the positive trends taking place, Jackson pointed out that disparities in access to palliative care persist, particularly in rural areas, posing significant obstacles to progress in the field. She also underscored workforce shortages.

“Shortages in skilled palliative care professionals, including physicians, nurses, chaplains, and social workers, have the potential to impact the quality of care provided,” Jackson said.

According to Abrahm, there are only about 7,600 trained palliative care physicians in the United States, compared with roughly 26,000 oncologists and only about 400 new specialists who receive training a year. 

Buckholz cautioned that stressed health care systems might revert to fee-for-service models — as is their tendency — with more focus given to relative value units (RVUs) for palliative care providers. 

“There’s this feeling of two steps forward and one or two steps back when it comes to implementing services,” Buckholz said. 

As the field continues to grow and evolve, future leaders will require diverse skill sets to provide effective, comprehensive care to seriously ill patients.

“[Future palliative care clinicians] need to be big thinkers … so they can figure out where palliative care can fit in, how it can fit as a technique for population health, how it can fit as a key element for minimizing risk, be it full or shared,” Abrahm said.

She added that future clinicians in this space need to be at c-suite tables making the case for palliative care in this greater context, and they must understand how their health care organizations are organized and the language of payers. In essence, they need leadership training and business skills, Abrahm told Palliative Care News. 

Buckolz and Jackson also emphasized the need for effective communication skills.

“Strong communication skills are critical not only for providing exceptional clinical care but also for advocating for the necessary resources to build robust care teams for seriously ill patients,” Jackson said.

Ultimately, the experts’ dedication to overcoming challenges within the field and advancing care is driven by a similar vision, according to Ananth. 

“My hope is that, in the coming years, every person with serious illness in this country, regardless of age, background, insurance, financial resources, location of health care, etc., will receive high-quality palliative and supportive care,” Ananth said.