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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25071.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25071.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25071.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25071.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25071.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25071.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25071.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25071.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25071.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25071.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25071.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25071.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25071.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25071.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25071.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25071.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25071.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25071.
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Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness PROCEEDINGS OF A WORKSHOP Laurene Graig, Elaine Soohoo, and Joe Alper, Rapporteurs Roundtable on Quality Care for People with Serious Illness Board on Health Care Services Board on Health Sciences Policy Health and Medicine Division PREPUBLICATION COPY: UNCORRECTED PROOFS

THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001 This activity was supported by contract No. HHSN263201200074I (Task Order No. HHSN26300096) with the National Institute of Nursing Research/National Institutes of Health and by Aetna Inc., Altarum Institute, American Academy of Hospice and Palliative Medicine, American Cancer Society, American Geriatrics Society, Anthem Inc., Ascension Health, Association of Professional Chaplains, Association of Rehabilitation Nurses, Blue Cross Blue Shield Association, Blue Cross Blue Shield of Massachusetts, the California State University Institute for Palliative Care, Cambia Health Solutions, Cedars-Sinai Health System, Center to Advance Palliative Care, Coalition to Transform Advanced Care, Common Practice, Dignity Health, Excellus BlueCross BlueShield, Federation of American Hospitals, The Greenwall Foundation, Hospice and Palliative Nurses Association, The John A. Hartford Foundation, Kaiser Permanente, the Gordon and Betty Moore Foundation, National Coalition for Hospice and Palliative Care, National Hospice and Palliative Care Organization, National Institute of Nursing Research, National Palliative Care Research Center, National Patient Advocate Foundation, National Quality Forum, Oncology Nursing Society, Patient-Centered Outcomes Research Institute, Sentara Healthcare, Social Work Hospice and Palliative Care Network, Supportive Care Coalition, Susan G. Komen, UnitedHealth Group, and the National Academy of Medicine. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project. International Standard Book Number – 13: 978-0-309 International Standard Book Number – 10: 0-309 Digital Object Identifier: https://doi.org/10.17226/25071 Additional copies of this publication are available for sale from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu. Copyright 2017 by the National Academy of Sciences. All rights reserved. Printed in the United States of America Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2017. Financing and payment strategies to support high-quality care for people with serious illness: proceedings of a workshop. Washington, DC: The National Academies Press. https://doi.org/10.17226/25071 PREPUBLICATION COPY: UNCORRECTED PROOFS

The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president. The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. C. D. Mote, Jr., is president. The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president. The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine. Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org. PREPUBLICATION COPY: UNCORRECTED PROOFS

Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s Statement of Task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the Statement of Task. Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies. For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo. PREPUBLICATION COPY: UNCORRECTED PROOFS

PLANNING COMMITTEE FOR A WORKSHOP ON FINANCING AND PAYMENT STRATEGIES TO SUPPORT HIGH-QUALITY CARE FOR PEOPLE WITH SERIOUS ILLNESS1 HAIDEN HUSKAMP (Co-Chair), 30th Anniversary Professor of Health Care Policy, Harvard Medical School MARK GANZ (Co-Chair), President and Chief Executive Officer, Cambia Health Solutions ROBERT BERGAMINI, Medical Director, Palliative Care Services, Mercy Clinic Children’s Cancer and Hematology, representing the Supportive Care Coalition PATRICIA BOMBA, Vice President & Medical Director, Geriatrics, Excellus BlueCross BlueShield STEPHEN FRIEDHOFF, Senior Vice President, Clinical Strategy and Programs, Anthem, Inc. LEE GOLDBERG, Director, Improving End-of-Life Care Project, The Pew Charitable Trusts ANNA GOSLINE, Senior Director of Health Policy and Strategic Initiatives, Blue Cross Blue Shield of Massachusetts ZIAD HAYDAR, Senior Vice President and Chief Clinical Officer, Ascension Health JOANNE LYNN, Director, Center for Elder Care and Advanced Illness, Altarum Institute JAMES MITTELBERGER, Director and Chief Medical Officer, Optum Center for Palliative and Supportive Care, UnitedHealth Group (through July 2017) SHARON SCRIBNER PEARCE, Vice President, Policy, National Hospice and Palliative Care Organization LEONARD D. SCHAEFFER, Judge Robert Maclay Widney Chair and Professor, University of Southern California ALLISON SILVERS, Vice President for Payment and Policy, Center to Advance Palliative Care Project Staff LAURENE GRAIG, Director, Roundtable on Quality Care for People with Serious Illness SYLARA MARIE CRUZ, Research Assistant SHARYL NASS, Director, Board on Health Care Services, and Director, National Cancer Policy Forum ANDREW M. POPE, Director, Board on Health Sciences Policy Consultant JOE ALPER, Consulting Writer 1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution. v PREPUBLICATION COPY: UNCORRECTED PROOFS

ROUNDTABLE ON QUALITY CARE FOR PEOPLE WITH SERIOUS ILLNESS1 LEONARD D. SCHAEFFER (Chair), Judge Robert Maclay Widney Chair and Professor, University of Southern California JAMES A. TULSKY (Vice Chair), Chair, Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute; Chief, Division of Palliative Medicine, Brigham and Women’s Hospital; Professor of Medicine and Co-Director, Center for Palliative Care, Harvard Medical School JENNIFER BALLENTINE, Executive Director, The California State University Institute for Palliative Care ROBERT A. BERGAMINI, Medical Director, Palliative Care Services, Mercy Clinic Children’s Cancer and Hematology, representing the Supportive Care Coalition AMY J. BERMAN, Senior Program Officer, The John A. Hartford Foundation PATRICIA A. BOMBA, Vice President and Medical Director, Geriatrics, Excellus BlueCross BlueShield GRACE B. CAMPBELL, Assistant Professor, Department of Acute and Tertiary Care, University of Pittsburgh School of Nursing, representing the Association of Rehabilitation Nurses STEVE CLAUSER, Program Director, Improving Healthcare Systems, Patient-Centered Outcomes Research Institute JEFF COHN, Medical Director, Common Practice JANET CORRIGAN, Chief Program Officer, Patient Care Program, Gordon and Betty Moore Foundation ANDREW DREYFUS, President and Chief Executive Officer, Blue Cross Blue Shield of Massachusetts CAROLE REDDING FLAMM, Executive Medical Director, Blue Cross Blue Shield Association STEPHEN FRIEDHOFF, Senior Vice President, Clinical Strategy and Programs, Anthem, Inc. MARK B. GANZ, President and Chief Executive Officer, Cambia Health Solutions ZIAD HAYDAR, Senior Vice President and Chief Clinical Officer, Ascension Health PAMELA S. HINDS, Director of Nursing Research and Quality Outcomes, Children’s National Health System HAIDEN HUSKAMP, 30th Anniversary Professor of Health Care Policy, Harvard Medical School KIMBERLY JOHNSON, Associate Professor of Medicine, Senior Fellow in the Center for the Study of Aging and Human Development, Duke University School of Medicine CHARLES N. KAHN III, President and Chief Executive Officer, Federation of American Hospitals REBECCA A. KIRCH, Executive Vice President of Healthcare Quality and Value, National Patient Advocate Foundation TOM KOUTSOUMPAS, Co-Founder, Coalition to Transform Advanced Care SHARI M. LING, Deputy Chief Medical Officer, Centers for Medicare & Medicaid Services BERNARD LO, President and Chief Executive Officer, The Greenwall Foundation 1 The National Academies of Sciences, Engineering, and Medicine’s forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution. vii PREPUBLICATION COPY: UNCORRECTED PROOFS

JOANNE LYNN, Director, Center for Elder Care and Advanced Illness, Altarum Institute DIANE E. MEIER, Director, Center to Advance Palliative Care AMY MELNICK, Executive Director, National Coalition for Hospice and Palliative Care JERI L. MILLER, Chief, Office of End-of-Life and Palliative Care Research, National Institute of Nursing Research, National Institutes of Health R. SEAN MORRISON, Director, National Palliative Care Research Center MURALI NAIDU, Vice President, Chief Clinical Officer, Sentara Healthcare BRENDA NEVIDJON, Chief Executive Officer, Oncology Nursing Society HAROLD L. PAZ, Executive Vice President and Chief Medical Officer, Aetna Inc. SHARON SCRIBNER PEARCE, Vice President, Policy, National Hospice and Palliative Care Organization JUDITH R. PERES, Long-Term and Palliative Care Consultant, Clinical Social Worker, and Board Member, Social Work Hospice and Palliative Care Network PHILLIP A. PIZZO, Founding Director, Stanford Distinguished Careers Institute; former Dean, Stanford School of Medicine and David and Susan Heckerman Professor of Pediatrics and of Microbiology and Immunology WENDY PRINS, Senior Advisor, Quality Innovation, National Quality Forum THOMAS M. PRISELAC, President and Chief Executive Officer, Cedars-Sinai Health System JOANNE REIFSNYDER, Executive Vice President, Clinical Operations and Chief Nursing Officer, Genesis Healthcare, representing the Hospice and Palliative Nurses Association JUDITH A. SALERNO, President, The New York Academy of Medicine KATRINA M. SCOTT, Oncology Chaplain, Massachusetts General Hospital, representing the Association of Professional Chaplains KATHERINE SHARPE, Senior Vice President, Patient and Caregiver Support, American Cancer Society, Inc. JOSEPH W. SHEGA, Regional Medical Director, VITAS Hospice Care, representing the American Geriatrics Society CHRISTIAN SINCLAIR, Outpatient Palliative Oncology Lead, Division of Palliative Medicine, University of Kansas Health System, representing the American Academy of Hospice and Palliative Medicine TANYA STEWART, Senior Medical Director, UnitedHealthcare Retiree Solutions SUSAN ELIZABETH WANG, Regional Lead for Shared Decision-Making and Advance Care Planning, Southern California Permanente Medical Group, Kaiser Permanente Roundtable on Quality Care for People with Serious Illness Staff LAURENE GRAIG, Director, Roundtable on Quality Care for People with Serious Illness SYLARA MARIE CRUZ, Research Assistant SHARYL NASS, Director, Board on Health Care Services, and Director, National Cancer Policy Forum ANDREW M. POPE, Director, Board on Health Sciences Policy PATRICK BURKE, Financial Associate ELAINE SOOHOO, Christine Mirzayan Science & Technology Policy Graduate Fellow (January –April 2018) viii PREPUBLICATION COPY: UNCORRECTED PROOFS

Reviewers This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We thank the following individuals for their review of this proceedings: Emily Chai, Mount Sinai School of Medicine Jeanne Chirico, Hospice & Palliative Care Association of New York State Torrie Fields, Blue Shield of California Robert Fine, Baylor Scott and White Health Vicky Jackson, Harvard Medical School Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by Betty Ferrell, City of Hope National Medical Center. She was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteurs and the National Academies. ix PREPUBLICATION COPY: UNCORRECTED PROOFS

Acknowledgments The National Academies of Sciences, Engineering, and Medicine’s Roundtable on Quality Care for People with Serious Illness wishes to express its sincere gratitude to the Planning Committee Co-Chairs Haiden Huskamp and Mark Ganz for their valuable contributions to the development of this workshop. We also wish to thank all the members of the planning committee, who collaborated to ensure a workshop complete with informative presentations and rich discussions. We are extremely grateful to the speakers and moderators, who generously shared their expertise and their time with workshop participants. Support from the many annual sponsors of the Roundtable on Quality Care for People with Serious Illness is critical to the Roundtable’s work. The sponsors include Aetna Inc., Altarum Institute, American Academy of Hospice and Palliative Medicine, American Cancer Society, American Geriatrics Society, Anthem, Inc., Ascension Health, Association of Professional Chaplains, Association of Rehabilitation Nurses, Blue Cross Blue Shield Association, Blue Cross Blue Shield of Massachusetts, the California State University Institute for Palliative Care, Cambia Health Solutions, Cedars-Sinai Health System, Center to Advance Palliative Care, Coalition to Transform Advanced Care, Common Practice, Dignity Health, Excellus BlueCross BlueShield, Federation of American Hospitals, The Greenwall Foundation, Hospice and Palliative Nurses Association, The John A. Hartford Foundation, Kaiser Permanente, the Gordon and Betty Moore Foundation, National Coalition for Hospice and Palliative Care, National Hospice and Palliative Care Organization, National Institute of Nursing Research, National Palliative Care Research Center, National Patient Advocate Foundation, National Quality Forum, Oncology Nursing Society, Patient-Centered Outcomes Research Institute, Sentara Healthcare, Social Work Hospice and Palliative Care Network, Supportive Care Coalition, Susan G. Komen, UnitedHealth Group, and the National Academy of Medicine. xi PREPUBLICATION COPY: UNCORRECTED PROOFS

Contents ACRONYMS AND ABBREVIATIONS xvii INTRODUCTION 1 PATIENT–CAREGIVER–CLINICIAN PERSPECTIVE ON MANAGING AND PAYING FOR SERIOUS ILLNESS CARE 5 FRAMING THE CHALLENGES AND OPPORTUNITES FOR FINANCING AND PAYMENT INNOVATION 8 Taking Care of a Seriously Ill Patient in the Context of the Current Health Care Financing System, 12 Discussion Session, 14 EXPLORING FINANCING AND PAYMENT INNOVATIONS: CHALLENGES, IMPACTS, AND LESSONS FROM FEE-FOR-SERVICE AND VALUE-BASED PAYMENT ARRANGEMENTS 16 Financing Serious Illness Care at Cambia Health Solutions, 17 CompassionNet: Community-Based Pediatric Palliative Care, 18 Anthem’s Enhanced Personal Health Care, 20 Lessons from CMS Demonstration Projects, 21 BSWH’s Journey Toward Value in Serious Illness Care, 23 Discussion, 25 VIEW FROM CONGRESS 26 EXPLORING FINANCING AND PAYMENT INNOVATIONS: CHALLENGES, IMPACTS, AND LESSONS FROM GLOBAL BUDGETING ARRANGEMENTS 27 Financing Quality Care for Serious Illness at Kaiser Permanente, 28 Global Payment Arrangements for Serious Illness Care in Massachusetts, 30 Complex Care Management at OptumHealth, 33 Discussion, 34 EXPLORING POTENTIAL REGULATORY AND POLICY CHANGES TO ENSURE HIGH- QUALITY CARE FOR PEOPLE OF ALL AGES WITH SERIOUS ILLNESS 36 Policy Opportunities, 37 Panel Discussion, 40 Closing Thoughts, 43 REFERENCES 44 APPENDIX A: STATEMENT OF TASK 47 APPENDIX B: WORKSHOP AGENDA 49 xiii PREPUBLICATION COPY: UNCORRECTED PROOFS

Box, Figures, and Table BOX 1 Suggestions Made by Individual Workshop Participants to Finance and Pay for High- Quality Care for People with Serious Illness, 3 FIGURES 1 Distribution of out-of-pocket spending in the last 5 years of life, 10 2 Deaths at home by age, 19 3 High rates of global payment adoption across payers and programs in Massachusetts, 30 TABLE 1 Cost and Location of Death at Five Moments in the Last Year of Life, 19 xv PREPUBLICATION COPY: UNCORRECTED PROOFS

Acronyms and Abbreviations ACO Accountable Care Organization AQC Alternative Quality Contract BCBSMA Blue Cross Blue Shield of Massachusetts BCBSNC Blue Cross Blue Shield of North Carolina BPCI Bundled Payments for Care Improvement BSWH Baylor Scott & White Health CHIP Children’s Health Insurance Program CMMI Center for Medicare & Medicaid Innovation CMS Centers for Medicare & Medicaid Services COBRA Consolidated Omnibus Budget Reconciliation Act COPD chronic obstructive pulmonary disease CPC Plus Comprehensive Primary Care Plus EHR electronic health record HEDIS Healthcare Effectiveness Data and Information Set I-SNP Institutional Special Needs Plan IMPACT Improving Medicare Post-Acute Care Transformation Act of 2014 MACRA Medicare Access and CHIP Reauthorization Act of 2015 NCQA National Committee for Quality Assurance OECD Organisation for Economic Co-operation and Development PACE Programs of All-Inclusive Care for the Elderly PPO preferred provider organization SNF skilled nursing facility SNP special needs plan xvii PREPUBLICATION COPY: UNCORRECTED PROOFS

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Millions of people in the United States live with serious illnesses such as cancer, heart disease, chronic obstructive pulmonary disorder (COPD), amyotrophic lateral sclerosis, Parkinson’s disease, and dementia—often for many years. Those facing serious illness have a range of interconnected medical and non-medical needs, and the way their care is financed has a large impact on the care they receive. Medicare is the predominant payer, but both Medicaid and private payers also play significant roles in financing care for serious illness. In an effort to address the complex needs of people with serious illness, public and private health care payers are testing innovative financing strategies and alternative payment models. These innovative approaches signal a gradual transition from the traditional-fee-for-service system that pays providers based on the quantity of services to a system based on the value of care provided and a heightened focus on improved quality of care at lower cost.

To explore this evolving financing and payment landscape for serious illness care within public- and private-sector programs, the Roundtable on Quality Care for People with Serious Illness developed a workshop, Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness. The workshop convened clinicians, researchers, policy analysts, and patient advocates, as well as representatives from academia, government and private health care plans, and insurers to discuss challenges and opportunities in financing high-quality care for people with serious illness. This publication summarizes the presentations and discussions from the workshop.

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