Forum Session

Caring for Patients with Advanced and Serious Illnesses: Changing Medical Practice and Patient Expectations
March 18, 2011


Carol V. O'Shaughnessy, MA


As medical treatment and technology have progressed, the lives of people with advanced and serious illnesses have been extended. A number of experts believe that the medical care system is not positioned to adequately address the needs of these people, many of whom live with the continuous physical, functional, mental, and emotional effects of their conditions. To improve care for these patients, a new field of medicine called palliative care has emerged. Although palliative care is not widely understood, it is aimed at people with serious and advanced illnesses, many of whom may never be "cured" or recover full functionality. It emphasizes management of pain and symptoms, communication among the treating physicians, coordination of medical and supportive services, assistance with patient decision-making about care, and support for caregivers. This Forum session discussed palliative care, its effect on patients and quality and costs of care, and current financing methods. Speakers also discussed the differences between palliative and hospice care, innovative partnerships between hospitals and community-based providers to extend palliative care, private insurance coverage, and barriers to broad adoption of palliative care programs.


Diane E. Meier, MD, Director of the Center to Advance Palliative Care, Director of the Hertzberg Palliative Care Institute, Mount Sinai School of Medicine (New York City); Kyle R. Allen, DO, Chief, Division of Geriatric Medicine, Medical Director, Post Acute and Senior Services, Summa Health System (Akron, Ohio); Marcia Wade, MD, Senior Medical Director, Aetna Medicare, Aetna (Princeton, New Jersey)

Slides from the presentations by Dr. Meier, Dr. Allen, and Dr. Wade are available for download.

Related Materials

  • Diane E. Meier, Steven L. Isaacs, and Robert G. Hughes, Palliative Care: Transforming the Care of Serious Illness (Princeton, New Jersey: Robert Wood Johnson Foundation, 2010)
  • R. Sean Morrison et al., “Cost Savings Associated With US Hospital Palliative Care Consultation Programs,” Archives of Internal Medicine, 168, no. 16 (September 8, 2008): pp. 1783-1790
  • Randall Krakauer, “Opportunities to Improve the Quality of Care for Advanced Illness,” Health Affairs, 28, no. 5 (September/October 2009): pp. 1357–1359
  • R. Sean Morrison et al. Palliative Care Consultation Teams Cut Hospital Costs For Medicaid Beneficiaries, Health Affairs,  30, no. 3 (March 2011): pp. 454-463

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