A Call to Action: Improving Value by Emphasizing Patient-Centered Care at the End of Life

Medical care during life's final stages is often poorly coordinated and inattentive to patient preferences, typically owing to a failure to ascertain each individual's goals. End-of-life care also consumes substantial health care dollars. For example, 30% of Medicare resources are expended on the 5% of beneficiaries who die each year,¹ and one-third of costs in life's last year is accounted for in life's last month.² Research indicates that physicians and health care professionals can do better. Studies have all shown improvement in clinical care by assessing end-of-life preferences,³ delivering value-congruent care,⁴ and coordinating the care recommended by different health care providers (ie, primary care practitioners, oncologists, surgeons, and palliative care clinicians who are specialized in addressing supportive needs as death approaches).⁵