Palliative care plays a vital role in improving quality of life for individuals living with serious illness and their caregivers. Yet, despite significant growth in the field over the past two decades, persistent structural challenges threaten the sustainability and reach of palliative care programs nationwide. Findings from the Center to Advance Palliative Care’s first annual Palliative Pulse survey reveal the scope of these concerns: more than 90% of palliative care leaders report uncertainty about the long-term viability of their programs, citing insufficient financial support, increasing demand for services, and workforce strain.
These pressures have direct implications for patient care. As demand for palliative services rises—driven in part by an aging population and the growing prevalence of chronic illness—clinicians must navigate complex clinical, administrative, and financial responsibilities with limited institutional support. Unlike many medical specialties, palliative care teams often lack access to dedicated billing staff, requiring clinicians to manage coding and reimbursement processes independently. This burden diverts time and attention from patient care and can lead to missed revenue opportunities, further undermining program sustainability.
In response to these systemic challenges, AVDF awarded a $600,000 grant in 2025 to the Center to Advance Palliative Care (CAPC), based at the Icahn School of Medicine at Mount Sinai. This investment supports a set of coordinated initiatives designed to strengthen both the financial and clinical infrastructure of palliative care delivery. Specifically, the grant advances three priorities: the development of a first-of-its-kind billing tool, the expansion of real-time clinical education, and support for CAPC’s National Seminar and pre-conference workshops.
The proposed billing tool addresses one of the most immediate operational barriers facing palliative care programs. By guiding clinicians through documentation and coding decisions in real time, the tool will help ensure that services are accurately captured and reimbursed. Designed for integration with electronic medical records, the tool will recommend appropriate billing codes as providers document patient encounters, thereby improving efficiency while reinforcing best practices in medical billing.
CAPC will make this resource broadly accessible to healthcare professionals for a modest annual fee, ensuring both usability and long-term sustainability. In parallel, CAPC will expand its existing billing and coding toolkit to help program leaders advocate for institutional support and collaborate more effectively with billing departments.
Complementing this operational innovation, CAPC will expand its clinical education offerings to include real-time, small-group workshops led by expert faculty. CAPC’s existing online courses have reached more than 150,000 learners, with over 91% reporting improvements in clinical practice. But survey respondents identified a need for more interactive, facilitated learning.
This need is particularly acute for complex and rapidly evolving areas of care, such as pain management, caregiver mental health, and emerging treatment modalities. Early evidence supports the effectiveness of this approach: a pilot workshop on managing chronic pain for patients with opioid use disorder significantly increased clinician confidence, with participants describing the experience as among the most practical and impactful professional development opportunities they had encountered.
In addition to these initiatives, AVDF supported CAPC’s 2025 National Seminar, a convening that brought together hundreds of healthcare professionals to engage with emerging research, policy developments, and best practices in palliative care. AVDF sponsored the pre-conference workshops that provided in-depth training on topics including team leadership, billing optimization, and health equity. These convenings play a critical role in fostering collaboration, disseminating knowledge, and strengthening the field’s collective capacity to respond to evolving healthcare needs.
CAPC’s work builds on a 25-year track record of advancing palliative care nationwide. The organization has supported more than 3,000 healthcare entities including hospitals, hospice agencies, and medical schools. CAPC has also contributed to the expansion of palliative care services to approximately 84% of U.S. hospitals. This growth reflects CAPC’s ability to identify emerging challenges and respond with practical, evidence-based solutions that strengthen both clinical practice and organizational capacity.
“The growth of palliative care over the last 25 years is due in large part to CAPC’s leadership on a national scale—equipping thousands of organizations in every state with education and resources to improve care for all people living with a serious illness—and their ability to assess and respond quickly to threats and opportunities in the field. These three new initiatives are no exception; CAPC continues to provide key resources at critical moments for the growth and sustainability of palliative care,” said Jessica Russell, AVDF Director of Operations.
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