The researchers assessed the relationship between use, quality and cost of palliative care across the settings in which this care is delivered, including community-base palliative care, hospital-based palliative care, community-based hospice, and inpatient hospice. Research questions included: (1) What is the relationship between palliative care use, quality, and cost in North Carolina palliative care programs; (2) What is the relationship between hospice use, quality, and cost in the Medicare program; and (3) Do newly developed quality metrics yield a similar pattern of use, quality, and cost in prospective North Carolina palliative care data? The objective of the proposal was to focus on quality and cost concurrently in assessing the value of palliative care and help inform policy around the development of sustainable financing mechanisms for this care.