Health Affairs Briefing

Advanced Illness And End-Of-Life Care

National Press Club

529 14th Street NW, Washington, DC (Metro Center)

Tuesday, July 11, 2017 9:00 a.m. - 12:45 p.m.


Twitter: Follow Live Tweets from the briefing @Health_Affairs, and join in the conversation with #endoflife Find us on Snapchat: healthaffairs


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Few areas of health care are as personal, or as fraught, as care for people with serious illnesses who are approaching death. At a point in their lives when their needs are often as much social and spiritual as they are medical, people are confronted with a fragmented, rescue-driven health care system that produces miraculous results but also disastrous failures.

As the nation's population of individuals over the age of 65 is expected to reach 84 million by 2050, addressing these challenges becomes increasingly important, requiring coordination across multiple sectors and levels of government. Innovations are needed to produce improvements in care delivery; better communication between clinicians, patients and families; greater uptake of advance care planning tools; and payment systems and policies that support patient needs and preferences. The July 2017 issue of Health Affairs, "Advanced Illness and End-of-Life Care" includes a comprehensive look at these issue and others.

On Tuesday, July 11, Health Affairs convened a forum at the National Press Club in Washington, DC, featuring panels of journal authors presenting topics including:

-Care At The End Of Life
-Financing & Spending
-Quality Of Care & Patient Preferences
-Hospice & Palliative Care

The program featured the following presenters:

-Melissa Aldridge, Associate Professor, Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, on Epidemiology And Patterns Of Care At The End Of Life: Rising Complexity, Shifts In Care Patterns And Sites of Death

-Rachelle E. Bernacki, Director of Quality Initiatives, Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute; Assistant Professor, Harvard Medical School; and Associate Director, Serious Illness Care Program, Ariadne Labs, on A Systematic Intervention To Improve Serious Illness Communication In Primary Care

-Julie Bynum, Associate Professor Geisel School of Medicine, Dartmouth, on High-Cost Dual Eligible Service Use Demonstrates Need For Supportive And Palliative Models Of Care

-Janet Corrigan, Chief Program Officer for Patient Care, Gordon and Betty Moore Foundation

-Katherine Courtright, Instructor of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine University of Pennsylvania Health System on Approximately One In Three US Adults Completes Any Type Of Advance Directive For End-Of-Life Care

-Robrecht De Schreye, Researcher, End of Life Care, University of Brussels, on Applying Quality Indicators For Administrative Databases To Evaluate End-Of-Life Care For Cancer Patients In Belgium

-Rachel Dolin, Fellow, David A. Winston Fellowship, on A Positive Association Between Hospice Profit Margin And The Rate At Which Patients Are Discharged Before Death


-Laura Hatfield, Associate Professor of Health Care Policy, Harvard Medical School, on Medicare Beneficiaries With Advanced Lung Cancer Experience Diverse Patterns Of Care From Diagnosis To Death

-Elaine Kelly, Senior Research Economist, Institute for Fiscal Studies, on End-Of-Life Medical Spending In Last Twelve Months Of Life Is Lower Than Previously Reported

-Judith Lucas, Associate Professor and Assistant Chair, Undergraduate Program, Seton Hall University College of Nursing, on CMS Strategies To Reduce Antipsychotic Drug Use In Nursing Home Patients With Dementia Show Some Progress

-Diane Meier, Director, Center to Advance Palliative Care, Mount Sinai School of Medicine, on A National Strategy For Palliative Care

-Susan Miller, Professor of Health Services, Practice and Policy, Brown University School of Public Health, on Increasing Veterans' Hospice Use: The Veterans Health Administration's Focus On Improving End-Of-Life Care

-Vincent Mor, Professor of Health Services, Policy & Practice, and the Florence Pirce Grant University Health, Brown University School of Public Health, Health Affairs Issue Adviser

-Dina Keller Moss, NARRATIVE MATTERS:Getting It Right At The End Of Life

-Martina Orlovic, Post Graduate Researcher, Imperial College London, on Analysis Of End-Of-Life Care, Out-Of-Pocket Spending, And Place Of Death In 16 European Countries And Israel

-Katherine Ornstein, Assistant Professor, Department of Geriatrics and Palliative Medicine and Institute for Translational Epidemiology, Icahn School of Medicine at Mt. Sinai, on A National Profile Of End-Of-Life Caregiving In The United States

-Rebecca Anhang Price, Senior Policy Researcher, RAND Corporation, on Black And Hispanic Patients Receive Hospice Care Similar To That Of White Patients When In The Same Hospices

-Joan Teno, Professor, Division of Gerontology and Geriatric Medicine, University of Washington Medicine, on Challenges Of Measuring Quality Of Community-Based Programs For Seriously Ill Individuals And Their Families

Health Affairs is grateful to Vincent Mor of the Brown University School of Public Health for serving as theme adviser. We also thank the Gordon and Betty Moore Foundation for its financial support of the issue and briefing.