The Hidden Crisis in Serious Illness Care and How We Fix It

Every year, millions of Americans with serious illnesses find themselves caught in a dangerous limbo: not sick enough to qualify for hospice, but far too ill to be served by our traditional healthcare system. The result is care that’s expensive, fragmented, and often traumatic. These patients are shuffled between a revolving door of emergency rooms and ICUs, enduring a cascade of aggressive interventions that don’t match their goals or improve their quality of life. This approach not only undermines quality, it drives healthcare spending through the roof, particularly in the last year of life.

This is the hidden crisis in serious illness care. And it’s getting worse.

At the root of the problem is what many in the field call the “hospice cliff.” Medicare’s current system largely splits ca