Department faculty study access to and use of hospice and other palliative care services provided in the community and across diverse care settings. They also study how quality and costs may be affected by the use of hospice and palliative care services. Pedro Gozalo has studied the overall cost to Medicare of hospice care in nursing homes, and he and colleagues are working with CMS to redesign hospice payment policy. Susan Miller is an expert on palliative care in nursing homes, and as such, she and colleagues have studied whether nursing home hospice enrollment is associated with lower acute care use and better care processes (such as pain management). Dr. Miller is also conducting the first comparative study of palliative care consults in nursing homes. Dr. Vincent Mor in a co-principal investigator on a nursing home cluster randomized trial of video-assisted advanced care planning in 2 nursing home systems. Center investigators also examine palliative care in the Veteran’s Administration system; Dr. Mor is studying whether newly diagnosed lung cancer patients treated in VA Medical Centers that use hospice/palliative care more receive less aggressive end of life care.