NASHP Leaders’ Summit: Views on the Current Congressional Debate
In signaling that it will craft its own health reform proposal, the U.S. Senate opens the door for new approaches to address cost, coverage, and access. In tandem, state officials are assessing the impact of potential changes and weighing their options. The National Academy for State Health Policy (NASHP) recently “took the pulse” of state health policy leaders, representing the geopolitical diversity of the states, to collect their thoughts about reform. Through a short survey, meetings, and a focus group of leaders representing insurance, Medicaid, governors’ offices, legislatures, and health insurance exchanges, these states identified both practical approaches and questions regarding the impact of possible Congressional action. This snapshot briefly summarizes the concerns of that disparate group of state officials, all engaged in implementing health reform.
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For individuals living with complex, often chronic conditions, and their families, palliative care can provide relief from symptoms, improve satisfaction and outcomes, and help address critical mental and spiritual needs during difficult times. Now more than ever, there is growing recognition of the importance of palliative care services for individuals with serious illness, such as advance care planning, pain and symptom management, care coordination, and team-based, multi-disciplinary support. These services can help patients and families cope with the symptoms and stressors of disease, better anticipate and avoid crises, and reduce unnecessary and/or unwanted care. While this model is grounded in evidence that demonstrates improved quality of life, better outcomes, and reduced cost for patients, only a fraction of individuals who could benefit from palliative care receive it. 
