PARTNERED WITH

One of the most important lessons I've learned in my medical training: involve the palliative care team early. This especially applies to the inpatient setting, when I'm caring for patients with cancer, sickle cell disease, or end-stage diseases where death is imminent.

But what about the outpatient setting? The vast majority of care happens outpatient—yet access to palliative care there is limited. If you're living in a rural area, you'd have better luck finding a needle in a haystack than finding a palliative care doctor. I’m not even joking.

As the population ages and people live longer with advanced chronic diseases, palliative care has a critical role to play. But, again, access is severely limited.

In this article, I'll highlight palliative and hospice care in the U.S., introduce you to Empassion—a company delivering high-value care to underserved populations—and share how I think about this space from the perspectives of patients, physicians, and payers.

Here's what I see in the hospital: we're really good at consulting palliative care for inpatients with advanced cancer or imminent death. We do it because it works. There’s better symptom control, clearer goals-of-care conversations, and fewer futile interventions.

But once patients leave the hospital, the support evaporates.

I can't send my clinic patients home with a meaningful palliative care referral. Community-based palliative care barely exists. Only 5% of palliative-eligible patients have access to home-based services, leaving families to navigate complex medical, emotional, and social needs alone. The downstream effects include repeated hospitalizations, fragmented care, and costs that spiral in the final months of life.

The numbers tell the story. The last year of life accounts for 25% of total Medicare expenditures. Most of that spending happens in the last six months, driven by hospitalizations, ICU stays, and aggressive interventions when hospice isn’t used. 

We know early palliative and hospice intervention changes this trajectory. Studies consistently show reduced hospitalizations, lower costs, and better patient outcomes when services start earlier. Early palliative intervention reduces hospital costs by ~$3,500 per patient. Timely hospice enrollment saves ~$12,000 in the last month of life.

Yet the median hospice length of stay remains just 18 days nationally, and only 50% of Medicare patients use hospice at end of life. Most patients are referred far too late to realize the full benefits.

Access is a huge barrier. Only 2.86 certified palliative care providers exist per 100,000 people, far short of what's needed as the U.S. population ages. Adults 65 and older will nearly double by 2060, from 56 million to 95 million, while chronic disease prevalence continues to climb.

We need scalable models that deliver coordinated care in the community, before patients reach the hospital. Models that give patients more good days at home. Models that align incentives around outcomes, not volume.

That's exactly what Empassion Health is building.

Empassion Health is a relatively new company that proves you don't have to choose between compassion and cost-efficiency. I learned about them through the Huddle community.

Empassion delivers community-based, in-home palliative care and appropriate hospice transitions for adults living with serious illness. Their model provides an extra layer of support for patients and caregivers before hospice eligibility—filling that critical gap where only 5% of Americans currently have access to community palliative care (review the section above!).

They have plenty of x-factors, but I’ll name the ones that stick out to me the most:

Empassion assessed their value-based palliative care model by comparing cost savings from the last 12-months of life between those under Empassion’s care and those not. I’ll quickly highlight below:

This study demonstrates that Empassion’s services and model, delivered at scale, lead to improved outcomes for people with serious illness and reduce the total cost of care.

What makes Empassion's model work is how its outcomes provide value for everyone in the healthcare system.

The patient value is obvious but worth stating clearly. Seventy percent of people with serious illness die in the hospital despite wanting to be at home. I see this constantly on the wards when patients become trapped in cycles of aggressive interventions that don't improve quality of life. Empassion's model delivers what patients actually want: coordinated care at home, addressing medical, emotional, and social needs together. The 90% satisfaction rate shows that the model aligns with patient preferences in a way our current system doesn't.

The physician value solves a real referral problem. In the hospital, I can consult palliative care with a single order. But in clinic, I have nowhere to send patients. Community palliative care barely exists, with only 5% of eligible patients having access. Empassion's network gives me national reach without capacity constraints. Even more important: the hospice-inclusive design eliminates the handoff failure that plagues most models. When 98% of Empassion's providers deliver both palliative and hospice, the transition is seamless. Same team, continuous relationships, no dropped balls.

The payer value is about scalability and risk alignment. The $28,000 per-patient savings (35% reduction) is compelling on its own. But what makes Empassion's model different is that it works at scale with the highest-acuity patients—89% had 3 or more comorbidities—proving it can handle the complex patients who drive disproportionate spend. The value-based payment structure puts Empassion's fees at risk, meaning they only win when outcomes improve. That's the kind of alignment payers need to manage high-cost populations.

Now, what do I think is most underappreciated about Empassion’s approach? They're not waiting for policy reform or payment transformation. They're showing their value-based model works right now, in the current regulatory environment, with existing Medicare and Medicare Advantage structures. Through the ACO REACH model, Empassion saved CMS $34 million.

The demographics make this urgent. By 2060, we'll have 95 million Americans over 65, nearly double today's number. Chronic disease prevalence is climbing. The current model—reactive, hospital-centric, volume-based—can't handle that surge. We need models that deliver coordinated care in the community, align incentives around outcomes, and scale without hitting workforce constraints.

Empassion is showing what that looks like in practice. They're delivering more good days for patients while reducing costs for the system. Both are possible. Both are measurable. Both are happening at scale.

About this post: This is a partnered deep dive with Empassion. The framework and conclusions, however, are my own. As a reminder, I only partner with companies solving real problems I'd write about anyway, and Empassion’s approach to palliative care fits that bar. As always, my goal is to give you a transparent breakdown of what works, what doesn't, and why it matters for patients, physicians, and the health system. If you or your company would be interested in a partnership like this, click here.

Credentialing companies were created to verify provider credentials and reduce administrative burden for hospitals. But today's 60-120 day timelines cost physicians and hospitals tens of thousands in lost revenue, even as the technology improves to make the process dramatically faster.

👉 Full breakdown in my latest Huddle+ article here.

If you’ve been trying to separate AI hype from reality, this course is built for you.

AI & Healthcare Utilization walks through real‑world use cases across hospitals, physician groups, and payers—how AI is actually being used to reduce waste, improve flow, and support better care, with concrete ROI numbers and frameworks you can apply in your own setting.

I dig into where AI meaningfully changes utilization (and where it doesn’t), which vendors are solving real problems vs adding noise, and what it takes to go from pilot to system‑wide adoption without burning out your clinicians or blowing up workflows.

👉 Course is live—enroll in “AI & Healthcare Utilization” here.

Have any hot takes for 2026? I’m compiling my 2026 healthcare predictions report and I want to feature predictions from the community!