PCHETA – Building the Workforce for Hospice and Palliative Care

Congress has once again introduced the Palliative Care and Hospice Education and Training Act (PCHETA), a bipartisan proposal aimed at addressing one of the most pressing challenges in serious illness and end-of-life care: the growing shortage of trained clinicians.  Sponsored in the House by Representatives Earl “Buddy” Carter (R-GA) and Ami Bera, M.D. (D-CA), with companion legislation in the Senate led by Senators Tammy Baldwin (D-WI) and Shelley Moore Capito (R-WV), the bill seeks to expand training, education, and research in hospice and palliative care while supporting the workforce needed to care for an aging population.

Why The PCHETA Bill Matters

Hospice and palliative care play a vital role in improving quality of life for patients with serious illness, offering relief from pain and symptoms, emotional support, and guidance for patients and families navigating complex decisions.  These services have also been shown to reduce unnecessary hospitalizations and health care costs.  Despite the value of this care, demand is outpacing supply.

The U.S. Census Bureau projects that by 2040 nearly 78 million Americans will be over 65, intensifying the need for specialized clinicians.  Yet, the field faces a significant shortage.  A 2010 report estimated a need for an additional 4,487 hospice physicians and 10,810 palliative care physicians to meet population needs.  The shortage is compounded by the fact that 40% of today’s workforce is over 56, meaning a large cohort is approaching retirement.

At the same time, burnout rates in hospice and palliative care exceed 38%, fueled by staffing shortages, increasing patient loads, and the emotional weight of the work.  Without intervention, the gap between patient needs and clinician availability will continue to widen.

What The PCHETA Bill Would Do

The latest version of PCHETA builds upon years of bipartisan support but has yet to be enacted into law despite repeated introductions in Congress.  The bill proposes a multi-pronged approach:

1. Education & Training – Expand fellowships, residencies, and interdisciplinary training for clinicians across disciplines, with incentives for continuing education and professional development.
2. Career Pathways – Create exposure and structured pathways for students and early-career professionals, including community-based training programs beyond academic centers.
3. Research & Awareness – Fund studies on care delivery and promote public and caregiver education on the benefits of hospice and palliative care.
4. Family Caregiver Support – Provide resources and training to help families manage care at home.

Industry Support

PCHETA has garnered endorsements from more than 100 national and state organizations, including the American Academy of Hospice and Palliative Medicine (AAHPM), National Partnership for Healthcare and Hospice Innovation (NPHI), LeadingAge, the Alzheimer’s Association, the National Alliance for Care at Home, the American Cancer Society Cancer Action Network, and numerous state hospice and home care associations.

Supporters stress that the bill is not only about workforce growth but also about ensuring patients and families receive timely, expert, and compassionate care.  Key groups highlight its potential to strengthen interdisciplinary teams, expand access for patients with serious illnesses, and prepare the workforce for the demands of an aging population.

Challenges Ahead

Despite broad support, the bill faces familiar hurdles.  PCHETA has been introduced several times, most recently in 2023, but has yet to become law.  Advocates remain hopeful that bipartisan backing and the growing urgency of workforce shortages will provide the necessary momentum.

For hospice leaders, the bill is more than a policy proposal.  PCHETA represents a strategic lifeline for the future of care delivery.  As agencies face mounting workforce challenges, PCHETA’s training pipelines, fellowships, and caregiver education provisions could directly influence staffing stability, clinical quality, and patient access.

Implications for Hospice Leaders

If passed, PCHETA could ease workforce pressures and strengthen care delivery.  Expanded training would improve retention, while earlier exposure in medical education could build a stronger pipeline of clinicians.  Investments in research and interdisciplinary education would raise care quality, and public awareness efforts could promote earlier referrals and better patient outcomes.

Looking Forward

For hospice leaders, staying engaged in policy advocacy around PCHETA will be crucial.  The bill aligns with the field’s pressing needs and offers a structured approach to addressing the workforce crisis.  Even as providers work within current staffing realities, preparing for the potential opportunities created by PCHETA – such as developing partnerships with academic institutions or expanding caregiver education programs – can position organizations to take advantage of future funding and training initiatives.

In a health care landscape where demand is rising and resources are stretched thin, PCHETA represents a critical investment in both the workforce and the quality of care delivered to patients and families.  Whether or not this Congress succeeds in passing it, the issues it addresses (burnout, staffing shortages, training gaps, and caregiver support) will remain central to the sustainability of hospice and palliative care.

Reference:  Read full bill text here.