Advance Directives Market

Market Definition

Advance directives are legal documents that allow individuals to specify their preferences for medical treatment in situations where they are unable to communicate their wishes. These directives typically include instructions on life-sustaining treatments, organ donation, and the designation of a healthcare proxy.

The scope of the market encompasses various forms, such as living wills and durable powers of attorney for healthcare, and they are utilized across healthcare settings, including hospitals, nursing homes, and hospice care. These documents are essential tools for ensuring that a person's healthcare preferences are honored, particularly in end-of-life situations.

Advance Directives Market Overview

The global advance directives market size was valued at USD 154.25 billion in 2024 and is projected to grow from USD 176.27 billion in 2025 to USD 510.20 billion by 2032, exhibiting a CAGR of 16.40% over the forecast period.

The growth of the market is driven by the adoption of digital health platforms that make patient preferences easily accessible across care settings. Additionally, the integration of digital platforms for advanced care planning, which simplifies documentation, enhances transparency, and drives wider adoption among patients and providers, is further strengthening the market growth.

Key Highlights

1. The advance directives industry size was valued at USD 154.25 billion in 2024.
2. The market is projected to grow at a CAGR of 16.40% from 2025 to 2032.
3. North America held a market share of 39.65% in 2024, with a valuation of USD 61.16 billion.
4. The software segment garnered USD 90.16 billion in revenue in 2024.
5. The above 65 years segment is expected to reach USD 211.94 billion by 2032.
6. The individuals segment secured the largest revenue share of 52.16% in 2024.
7. The online platforms segment is poised for a robust CAGR of 18.32% through the forecast period.
8. Asia Pacific is anticipated to grow at a CAGR of 18.05% during the forecast period.

Major companies operating in the advance directives market are Kaiser Foundation Health Plan Inc., Providence Health & Services, Lantern Health Inc., Dignity Health, Geisinger Health System, Tunstall Healthcare Group, General Electric Company, Siemens, Ascom, FreeWill Co., Five Wishes, Everplans, Cake Health, MyDirectives, and Honoring Choices.

Rising cases of cancer, dementia, and cardiovascular diseases are driving the growth of the market. The World Health Organization states that Cardiovascular diseases (CVDs) are the top cause of death worldwide, responsible for approximately 17.9 million fatalities annually. Patients facing long-term illnesses are increasingly planning future medical decisions to ensure their preferences are respected during critical health situations.

Families are recognizing the importance of advance directives in reducing uncertainty and avoiding conflicts during emergency care. Healthcare providers are encouraging patients with chronic conditions to formalize their wishes, which is strengthening adoption. Legal professionals are also supporting individuals in drafting directives to ensure compliance with medical and legal standards.

Market Driver

Integration with Digital Health Platforms

Integration of advance directives with digital health platforms is driving the growth of the advance directives market. Online portals are enabling individuals to create and update their care preferences more conveniently. Electronic health records are allowing healthcare providers to access patient directives instantly during treatment, reducing delays in decision-making. 

Individuals are benefiting from secure digital storage that ensures documents are available when needed. Hospitals and clinics are adopting integrated platforms to improve compliance with patient wishes and regulatory requirements. The shift toward digital health ecosystems is strengthening the visibility, accessibility, and adoption of advance directives, supporting market expansion.

• In February 2025, Backline by DrFirst, Five Wishes, and MyDirectives launched ACP Complete, a comprehensive end-to-end digital Advance Care Planning (ACP) solution. The service guides users through creating their ACP documents via virtual consultations with certified facilitators, supports video-based documentation via MIDEO Health, and securely stores completed directives in a national registry accessible to providers.

Market Challenge

Lack of Awareness and Cultural Barriers

A key challenge in the advance directives market is the limited understanding among individuals about the purpose and importance of documenting end-of-life care preferences. Many individuals avoid or delay these discussions due to cultural sensitivities, emotional reluctance, or misconceptions about advance care planning. These factors reduce adoption, even in regions where supportive legal and healthcare frameworks are available.

To address this challenge, market players are conducting public awareness campaigns, integrating education on advance directives  into healthcare settings, and collaborating with community organizations to encourage open discussions.

Market Trend

Integration of Digital Platforms for Advanced Care Planning

The advance directives market is evolving through the introduction of secure digital platforms that simplify care planning processes. Cloud-based systems and mobile applications enable patients to draft, update, and store their directives in accessible formats. These tools also allow real-time sharing with healthcare providers, ensuring that patient preferences are available during critical care situations. 

Enhanced accessibility and security features improve compliance with legal and medical standards, reducing the risk of miscommunication. The use of digital platforms is making advanced care planning more transparent, convenient, and integrated into routine healthcare practices.

• In April 2024, Five Wishes transitioned its digital advance care planning program to MyDirectives' secure, cloud-based platform. This migration enables individuals and their families to electronically sign, store, update, and share Advance Care Planning (ACP) documents, including Five Wishes directives and POLST forms across the U.S.

Advance Directives Market Report Snapshot

Market Segmentation

• By Component (Software and Services): The software segment earned USD 90.16 billion in 2024 due to the growing adoption of digital platforms that enable seamless documentation, storage, and accessibility of patient preferences across healthcare systems.
• By Age Group (18-39 years, 40-64 years, and above 65 years): The above 65 years segment held 44.96% of the market in 2024, due to the higher prevalence of chronic illnesses and increased need for end-of-life care planning in this age group.
• By End User (Individuals, Hospitals and Clinics, and Legal Professionals): The individuals segment is projected to reach USD 281.93 billion by 2032, owing to the rising demand for documenting personal healthcare preferences and ensuring control over end-of-life decisions.
• By Distribution Channel (Online Platforms, Healthcare Providers, and Government & Non-Government Organizations): The online platforms segment is poised for significant growth at a CAGR of 18.32% through the forecast period, attributed to increasing adoption of digital tools that enable easy creation, storage, and accessibility of directive documents for both patients and healthcare providers.

Advance Directives Market Regional Analysis

Based on region, the market has been classified into North America, Europe, Asia Pacific, Middle East & Africa, and South America.

The North America advance directives market share stood at 39.65% in 2024 in the global market, with a valuation of USD 61.16 billion. This dominance is driven by the presence of well-defined laws and state-level regulations in this region that make advance directives legally recognized documents. These clear rules give individuals and families confidence that their preferences will be respected. 

Healthcare providers in the region are also required to follow compliance standards, which drives the need for structured documentation. This alignment between legal frameworks and healthcare practices facilitates smoother and more reliable adoption of advance directives, in turn, driving market growth in this region.

In December 2024, the Improving Access to Advance Care Planning Act (S.3) proposed to amend the Social Security Act in the U.S., proposing the waiver of cost-sharing for advance care planning services under Medicare. This legislation aims to reduce financial barriers for patients seeking to formalize advance directives through covered healthcare services.

The advance directives industry in the Asia Pacific is poised for a CAGR of 18.05% over the forecast period. This growth is due to theis being driven by the rollout of legal frameworks in several countries that formally recognize the advance directives across the region. 

These frameworks are giving individuals a formal path to record their treatment preferences. Hospitals and care institutions in the region are beginning to adjust policies to align with these legal changes. This is creating an environment where advance directives are increasingly viewed as valid and enforceable documents.

• In July 2025, Singapore’s Ministry of Health, in collaboration with AIC and GovTech, launched myACP, a free online Advance Care Planning (ACP) tool. This platform allows generally healthy individuals to self-document care preferences without needing facilitator assistance. Over 77,000 ACPs were completed by July 11, 2025, reflecting a 40% increase compared to totals from 2011 to 2024.

Regulatory Frameworks

• The U.S. regulates advance directives through the Patient Self-Determination Act of 1990, which became effective in 1991. This law requires hospitals, nursing homes, hospices, home health agencies, and health maintenance organizations to inform adult patients of their right to create advance directives.
• Germany governs advance directives through the Patientenverfügungsgesetz law, introduced in 2009. The law states that a written, dated, and signed directive is legally binding for healthcare professionals if it is clearly formulated. Physicians are required to follow the documented wishes of the patient, and the directives can be revoked at any time without formalities.
• South Korea regulates advance directives under the Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment, effective February 2018. Adults over 19 can prepare advance directives at government-designated agencies, and these are stored in a national registry managed by the Ministry of Health and Welfare.

Competitive Landscape

Major players in the advance directives industry are adopting strategies such as integrating advance directive solutions into electronic health records to remain competitive in the market. Companies are focusing on partnerships with healthcare providers to ensure that patient preferences are accessible during treatment. Market players are also investing in technology platforms that allow secure storage and exchange of directive documents across different care settings. 

• In April 2025, Ochsner Health implemented MyDirectives for Clinicians within its Epic EHR system. ACP documents, including Five Wishes directives can be documented seamlessly and stored in the A|D Vault Exchange registry. Clinicians can engage with advance care planning conversations directly, ensuring patient preferences are accessible across care settings.

Key Companies in Advance Directives Market:

• Kaiser Foundation Health Plan Inc.
• Providence Health & Services
• Lantern Health Inc.
• Dignity Health
• Geisinger Health System
• Tunstall Healthcare Group
• General Electric Company
• Siemens
• Ascom
• FreeWill Co.
• Five Wishes
• Everplans
• Cake Health
• MyDirectives
• Honoring Choices

Recent Developments (Partnerships/Agreements/Expansion)

• In September 2025, MyDirectives and KanTime announced integration of MyDirectives’ ACP tools into KanTime’s EHR. This allows home health, hospice, palliative, and home care providers using KanTime to embed advance directives, POLST forms, Five Wishes, and mental health advance directives directly into clinician workflows via the A|D Vault Exchange registry.
• In May 2025, Koda Health partnered with Medical Home Network (MHN) to deliver digital ACP tools through Federally Qualified Health Centers (FQHCs). This collaboration provides underserved patients with access to AI-enhanced advance care planning tools, real-time provider access to completed directives, and expert support when needed.
• In March 2025, Heidi Health secured USD 10.6 million in Series A funding to expand its AI-powered medical scribe platform. The technology integrates with leading  EHR systems, such as Epic, Athenahealth, and MediRecords, to automate clinical documentation and workflows.