When a person is diagnosed with a serious illness—whether it’s cancer, heart failure, COPD, or advanced kidney disease—the emotional toll can be as debilitating as the physical symptoms. Anxiety, depression, fear of the future, and a loss of identity often go unspoken and unaddressed, quietly compounding the burden of disease.
As health plans and providers strive to deliver whole-person, value-based care, we must recognize that treating the body is only part of the equation. Mental and emotional well-being are critical dimensions of serious illness, and they demand more focused attention. Fortunately, we have a powerful but often underutilized ally: palliative care.
The overlooked mental health crisis in serious illness
According to multiple studies, up to 40% of patients with advanced cancer experience clinical depression. Anxiety and spiritual distress are also common, particularly when facing the unknown or confronting the loss of autonomy. For those managing progressive illnesses over time, mental health concerns can erode treatment adherence, accelerate physical decline, and strain family caregivers.
In traditional medical models, these symptoms are frequently interpreted as “understandable reactions” or are treated in isolation from the illness itself. Behavioral health services may be siloed if engaged, and primary care providers may not have the training or bandwidth to manage complex emotional needs alongside chronic disease.
Palliative care: A holistic approach to suffering
Palliative care is specialized medical care for people living with serious illness. It focuses on relief from the symptoms and stress of the disease—physical, emotional, and spiritual. The goal is to improve quality of life for both patients and their families.
What sets palliative care apart is its interdisciplinary model: teams typically include not only physicians and advanced practice nurses, but also social workers, case managers, triage nurses, and mental health professionals. This allows for comprehensive, compassionate care that meets people where they are—emotionally as well as physically.
Crucially, palliative care can be provided alongside curative or life-prolonging treatments. It’s not about “giving up.” It’s about helping people feel better, think clearly, and make empowered decisions about their care.
Why health plans should consider palliative care
For health plans, the implications are both clinical and financial. Mental health distress contributes to emergency visits, hospitalizations, and poor medication adherence. It affects the patient experience and drives up avoidable utilization. Addressing these issues proactively through palliative care has been shown to:
- Reduce hospital admissions and readmissions1, 2
- Improve patient and caregiver satisfaction3, 4
- Lower total cost of care, especially in the last year of life5, 6
- Increase alignment of care with patient goals7, 8
Palliative care can support value-based strategies by delivering measurable improvements in quality and cost. For Medicare Advantage, Medicaid, and commercial plans alike, it represents a smart investment in sustainable, person-centered care.
A call to action for providers
Providers have a critical role to play. Integrating palliative care earlier in the illness journey—not just at end-of-life—can transform how patients experience care. Hospitals can embed palliative consults in oncology, cardiology, and intensive care units. Outpatient clinics can partner with palliative teams to support care transitions. Telehealth can extend services to rural and underserved populations.
Moreover, provider organizations should view mental health as a core component of serious illness care, not a separate issue. Embedding behavioral health specialists within palliative teams and training clinicians in empathetic communication can dramatically improve patient outcomes.
Ultimately, it’s about whole health
The intersection of serious illness and mental health is not a niche concern—it is a central challenge for modern healthcare. Given that our nation’s 65+ population is expected to double over the next 30 years, health plans and providers have a shared responsibility to move beyond reactive models and invest in holistic, compassionate care.
Palliative care is not just for the final days of life. It’s a powerful tool to restore dignity, reduce suffering, and help people live better—even in the face of serious illness.
It’s time to meet our patients not only with science, but with humanity.
Dr. Simeon Kwan is medical director at Carelon Health and Dr. Rowland Pearsall is staff vice president and medical director at Carelon Behavioral Health
¹ Temel, J. S., Greer, J. A., Muzikansky, A., et al. (2010). Early palliative care for patients with metastatic non–small-cell lung cancer. New England Journal of Medicine, 363(8), 733–742.
² Morrison, R. S., Penrod, J. D., Cassel, J. B., et al. (2008). Cost savings associated with US hospital palliative care consultation programs. Archives of Internal Medicine, 168(16), 1783–1790.
³ Bakitas, M., Lyons, K. D., Hegel, M. T., et al. (2009). Effects of a palliative care intervention on clinical outcomes in patients with advanced cancer: The Project ENABLE II randomized controlled trial. JAMA, 302(7), 741–749.
⁴ National Hospice and Palliative Care Organization (NHPCO). Facts and Figures: Hospice Care in America. Various reports.
⁵ Center to Advance Palliative Care (CAPC). Palliative Care: Improving Care and Reducing Costs. Retrieved from https://www.capc.org
⁶ May, P., Garrido, M. M., Cassel, J. B., et al. (2015). Prospective cohort study of hospital palliative care teams for patients with advanced cancer: Impact on cost of care. Health Services Research, 50(4), 1040–1057.
⁷ Bernacki, R. E., & Block, S. D. (2014). Communication about serious illness care goals: A review and synthesis of best practices. JAMA Internal Medicine, 174(12), 1994–2003.⁸ National Consensus Project for Quality Palliative Care. (2018). Clinical Practice Guidelines for Quality Palliative Care, 4th Edition. Retrieved from https://www.nationalcoalitionhpc.org/ncp/
