The principles of hospice care embrace holistic patient- and family-centered care, offered by an interprofessional team of practitioners. Built on the foundation of hospice care, palliative care (PC) addresses care of the mind, body, and spirit as health practitioners develop the most effective and appropriate plan of care for and with patients and families experiencing serious, life-threatening, progressive, or chronic illnesses. As a new paradigm of healthcare, PC is responsive to the need for healthcare reform in America and globally. This chapter presents an exemplary palliative care action plan developed in the state of Maryland. In both generalist and specialist roles in palliative and hospice care, nurses are leaders of healthcare reform in the United States as they combine knowledge, experience, and commitment to advancing the specialty and promoting quality palliative and end-of-life care. The chapter discusses the roles of advanced practice palliative care nurses.