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Over the last 10 years the number of palliative care teams in hospitals has more than doubled. Yet despite the myriad benefits of palliative care, as well as its recent growth, much more progress is needed. Millions of Americans facing serious illness do not yet have access to palliative care from the point of diagnosis throughout the course of illness. Availability also varies considerably by region and by state.  The following findings, taken from America's Care of Serious Illness: A State-by-State Report Card on Access to Palliative Care in Our Nation's Hospitals (www.capc.org/reportcard/), represents an update of the previous 2008 Report Card issued by the Center to Advance Palliative Care (CAPC) and the National Palliative Care Research Center (NPCRC). The report highlights the current prevalence of hospital palliative care in the United States by examining variation in access to palliative care at the state level.