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Gaps in Advance Care Planning: Only 5% of Americans Have a Plan in Place

by Jasmine Pennic 07/16/2025 Leave a Comment

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Gaps in Advance Care Planning: Only 5% of Americans Have a Plan in Place

What You Should Know: 

– A recent survey conducted by The Harris Poll and commissioned by Backline by DrFirst reveals a significant national shortfall in advance care planning. Only 5% of Americans currently have an advance care plan in place, and half (50%) are largely unfamiliar with the concept. The research highlights substantial emotional and practical hurdles, alongside a strong desire for healthcare provider guidance.

– Advance care planning is the process of deciding and communicating future medical care preferences, regardless of age or current health status. It involves personal reflection, discussions with loved ones and providers, and designating a healthcare agent to ensure wishes are followed. These plans should be documented, shared, and periodically reviewed.

Barriers to Advance Care Planning

The Backline by DrFirst/Harris Poll survey identified several key barriers preventing Americans from engaging in advance care planning:

  • Limited Familiarity: A striking 50% of Americans are either “not at all familiar” (29%) or “only know the name” (21%) of advance care planning.
  • Emotional and Practical Hurdles:
    • 63% find thinking about advance care planning emotionally difficult.
    • 57% believe the process is complicated and/or time-consuming.
    • 34% mistakenly think it’s only needed for specific groups, such as the very sick, terminally ill, or those aged 65 or older.
  • Overestimated Family Confidence: While 74% are confident their family knows their healthcare wishes if they can’t speak for themselves, only 30% are “strongly confident”. A notable 26% lack confidence, with 8% strongly believing loved ones would not know their preferences.

“Advance care planning can be a sensitive topic, but it’s crucial that these conversations happen,” said Colin Banas, M.D., chief medical officer for Backline by DrFirst. “I tell patients it’s one of the most meaningful gifts you can give your loved ones, sparing them the burden of making difficult decisions during a medical emergency. This data makes it clear that people want guidance, support and simpler ways to take that first step.”

Growing Demand for Provider-Initiated Discussions

Despite the low rates of advance care plan completion, there is a clear demand for healthcare provider involvement. A significant 66% of Americans want their healthcare provider to initiate advance care planning conversations. This desire is even higher among parents of children under 18 (74%) compared to those without children under 18 (63%).

“While few have an advance care plan, it’s encouraging that two-thirds want their providers to bring up the subject,” Dr. Banas added. “However, given the emotional difficulty and perceptions of it being complicated and time-consuming, simply bringing up the topic won’t be enough. New technology can now bridge this gap, making it easier for patients to document their preferences for family and providers.”

Survey Background/Methodology

The survey was conducted online within the U.S. by The Harris Poll on behalf of Backline by DrFirst from April 29 – May 1, 2025, among 2,098 adults aged 18 and older. The sampling precision is accurate to within +/- 2.5 percentage points using a 95% confidence level.

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