Timing matters: Impact of early advance care planning conversations on hospice utilization in outpatient oncology

Timing matters: Impact of early advance care planning conversations on hospice utilization in outpatient oncology
JCO Oncology Practice, An American Society of Clinical Oncology Journal; by Lydia Mills, Malia Albin, Ami Gorsky-Zabukovic, Liz Hutchison, Molly Mendenhall, and Robyn Tibert; 10/7/25  
Results: 53% of physicians interviewed defined [Advance Care Planning] ACP as hospice, end-of-life, or code status conversations. This group of providers preferred waiting to conduct ACP discussions until later in a patient’s disease trajectory. However, 33% of physicians interviewed viewed ACP as broader discussions, to include patients’ values, goals and preferences for EOL care. These physicians stated they engage in ACP conversations as early as the first or second visit, especially with patients who have Stage IV disease or have a poor prognosis, introducing hospice as a potential option and revisiting these discussions throughout the course of treatment. PI data showed that providers who engage in early and consistent ACP discussions have a 17% higher hospice enrollment rate compared to their peers.