Advance care planning helps to align a patient’s health care and interventions with their beliefs, values, and preferences, in the event they become unable to make those decisions.¹ Making these key decisions early and thoughtfully can lead to decreased psychological distress and hospitalizations, improved end-of-life care and quality of life, better awareness of available treatment options, and ultimately, compliance with patient wishes.¹ Despite the benefits that advance care planning can provide, only 31 percent of adults in the United States have created a living will or an advance health care directive.²

As a trusted health care advisor for your patients, you can help raise awareness about the importance of advance care planning and encourage your patients to consider or take action on creating a plan.

Starting the conversation

Discussing advance care planning with your patients is not always easy, especially if your patient is currently healthy or has other health care providers. The patient may feel that it’s not the right time, that a conversation isn’t necessary, or that they are not comfortable starting the conversation themselves. Broaching these conversations with your patients — regardless of their health status or how ready they may feel — can help them begin to consider their values, clarify what matters most, prepare loved ones for future decisions, and strengthen continuity across their care team.

Some strategies for starting discussions about advance care planning with your patients include:

• Inquiring about advance directives upon hospital admissions and annual wellness visits.³
• Providing patients with validated, easy-to-use advance care planning tools.⁴
• Using scripts and communication guides.⁴
• Making these discussions a team-based process, working with interdisciplinary team members, which can encourage greater participation with patients and set a positive tone for future conversations.⁴

The importance of documenting advance directive discussions in medical records

Documenting advance care planning discussions, patient preferences, and completed advance directives in patient medical records supports care coordination, ensures accessibility for the care team, and meets documentation expectations during annual audits.

Some states require health plans to review medical record documentation. As part of the annual Cigna Healthcare^® Ambulatory Medical Record Review, the Cigna Healthcare Quality Program looks for information regarding advance directive discussions to ensure they are occurring between network-participating providers and customers. Learn more about our ambulatory medical record review process in Ambulatory medical record reviews.

Additional resources

Below are some additional resources from Cigna Healthcare that you can share with your patients to help them learn more about advance care planning and its importance:

• Advance Care Planning
• Advance Directives

1. National Committee for Quality Assurance (NCQA). “Advance Care Planning (ACP).” NCQA. 2026. Retrieved from https://www.ncqa.org/report-cards/health-plans/state-of-health-care-quality-report/advance-care-planning-acp/.
2. Luona Lin and Juliana Menasce Horowitz. “Experiences with estate planning and discussing end-of-life preferences.” Pew Research Center. 06 November 2025. Retrieved from https://www.pewresearch.org/social-trends/2025/11/06/experiences-with-estate-planning-and-discussing-end-of-life-preferences/.
3. Steven House, et al. “Advance Directives.” StatPearls. 05 May 2025. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK459133/.
4. Ryan McMahan, et al. “What Clinicians and Researchers Should Know About the Evolving Field of Advance Care Planning: a Narrative Review.” Journal of General Internal Medicine. 02 January 2024. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC10973287/.