Why Can't I Have Both? – the Imperative for Concurrent Disease-directed and Palliative Care

Outcomes1. Outline the key benefits, challenges, and policy implications of concurrent care.2. Compare concurrent care for children and new opportunities to provide it for adults through innovative hospice and palliative care models.3. Increase their skill in using clear and consistent language to describe and advocate for concurrent care.4. Synthesize the findings of a recent national convening and consider what they can do to advocate for supportive policies.Key MessageWhen patients must quit disease-directed treatments to get palliative care, they suffer if they're not ready to make the tradeoff. Concurrent care for children and veterans should be expanded and guide efforts in other populations. National stakeholders recently gathered to find common language to promote concurrent care for all.IntroductionPayment rules that make patients quit disease-directed treatments to get palliative care, such as dialysis restrictions for hospice patients, put those who aren't ready for the tradeoff in a bind and may extend their suffering. Lack of concurrent care options contributes to disparities in hospice care1. Concurrent care is now mandated for children and supported in the Veteran's Administration system. New alternative payment models may allow concurrent care, but access is limited. Lack of clarity in terminology used to describe concurrent care poses a policy challenge. A recent convening of national stakeholders focused on finding common language.Objectives1. Introduce concurrent care and outline its policy implications, 2. Illustrate benefits and challenges of current and potential new models of concurrent care, 3. Highlight the need for clear and consistent language and 4. Consider how we can work together to promote broader access.Methods and ResultsIn this panel discussion, hospice, pediatric, and public policy experts from AAHPM, the National Coalition for Hospice and Palliative Care (Coalition), and the National Hospice and Palliative Care Organization (NHPCO) will discuss the benefits, challenges, and policy implications of concurrent care, illustrate how it works for children, highlight opportunities for adults in innovative hospice and palliative care programs, and report on the proceedings of a national stakeholder convening to define concurrent care hosted by the Coalition and NHPCO on February 6, 2024.ConclusionTo ensure that people with serious illness always receive the right care at the right time, we need policies that support concurrent disease-directed and palliative care.KeywordsAdvocacy/Policy/Regulations/Models of Palliative Care Delivery