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I t is well documented that advance care planning (ACP) improves shared decision-making and quality of care. Recognizing the importance of ACP, the Centers for Medicare & Medicaid Services provides an opportunity for providers (physicians, clinical nurse specialists, nurse practitioners, and physician assistants) to bill for conducting conversations with their patients about end-of-life decisions with or without completing relevant legal forms. The two Current Procedural Terminology codes used to report ACP services are 99497 (for the first 30 minutes) and 99498 (add-on for each additional 30 minutes). No specific diagnosis is required for the ACP codes to be billed. Despite it being a billable service, the completion of ACP remains low. In a large national study published in this edition of the Journal of the American Geriatrics Society, Gupta et al analyzed the Medicare fee-for-service beneficiary decedent data from 2017 for presence or absence of billed ACP visits (none, >1 month before death) and their association with six measures of end-of-life healthcare utilization or intensity (inpatient admission, emergency department visit, intensive care unit [ICU] stay and expenditures within 30 days of death, in-hospital death, and first hospice within 3 days of death). They found that of the 237,989 decedents reviewed, a mere 6.3% of patients had a billed ACP visit. Further analyses of the decedentsʼ healthcare utilization patterns in the last month of life revealed that 52.8% had visited the emergency room, 48.0% were hospitalized, 18.5% were admitted to the ICU, and 21.7% died in the hospital. The authors state that patients who are given an opportunity to complete ACP and memorialize their preferences are less likely to utilize ineffective and burdensome treatments in the last phase of life, and we agree with them. Additionally, we believe that the completion of a billable ACP visit with a provider is necessary but not sufficient to facilitate goal-concordant care for all seriously ill older adults. We argue that it is vital that patients and families are provided with longitudinal structured coaching and ongoing decision support throughout the serious illness process. We advocate for a longitudinal model and have described some examples, as below: In a single-site, randomized, clinical trial, we have shown that a longitudinal structured coaching and ongoing support model is effective in an outpatient oncology setting. Lay health workers were formally trained (80-hour online training and 4-week clinical observation of a palliative team) to serve as liaisons and provide support to older adults through a systematic protocol that involved an initial 30-minute telephone conversation with the patient, followed by 15-minute, twice-monthly conversations by telephone or in person for a period of 6 months or until patient death, whichever came first. This intervention proved to increase documentation of goals of care, patient satisfaction, and hospice utilization while concurrently decreasing costs of care. The longitudinal patient-family liaison model has been used successfully in the novel coronavirus pandemic. The median time between the occurrence of the first coronavirus disease 2019 (COVID-19) symptom to death is 14.0 days (range = 6–41 days) and is even shorter in older adults, at 11.5 days (range = 6–19 days). A highly contagious disease, COVID-19 has a largely unpredictable course and a high percentage of fatality, especially in older adults. COVID-19 patients have a high prevalence of delirium, and many afflicted older adults become critically ill and are unable to make medical decisions. To complicate this already terrible situation even further, hospitals caring for COVID-19 patients have been forced to curtail visitation rights of family members in an effort to contain disease spread and due to shortage of personal protective equipment. Thus, hospitalized COVID-19 patients are completely isolated from their loved ones. Family members of COVID19 patients are themselves facing the tremendous physical, financial, and emotional toll imposed by the pandemic in addition to being forced to make decisions for their hospitalized loved ones, sight unseen. To allay the desperate worries of the family members of COVID-19 patients, the NewYork-Presbyterian/Columbia University Medical Center created a virtual, longitudinal family liaison program, staffed by a team of anesthesiologists, surgeons, and nurse practitioners. All liaisons were experienced critical care clinicians who were well familiar with the medical and the organizational cultural intricacies of the ICU. Each liaison was assigned a caseload of up to 12 critically ill COVID-19 DOI: 10.1111/jgs.16684