OBJECTIVES: Studies suggest that end-of-life (EOL) care for persons with cancer in the United States is variable and misaligned with patient and family preferences.  To better understand this issue, a regional collaboration of patients, clinicians, researchers and health plan representatives identified high-priority quality indicators for palliative care. We then measured those indicators using cancer registry records linked with insurance claims. METHODS: Surveillance, Epidemiology, and End Results (SEER) records for solid tumor patients diagnosed with cancer in Western Washington State between January 1, 2007 and May 31, 2014 were linked with enrollment and claims from two regional commercial insurance plans.  Using claims and SEER records, algorithms were developed to characterize end-of-life care. RESULTS: Utilization of specific services in the last 30 days of life were as follows: chemotherapy or radiation therapy (24%); CT, MRI or PET scans (49%),  hospital admission and emergency department visit (63%);  Hospice service (16%); narcotic pain medication (52%) The patient’s location or service at death was as follows: hospice care inpatient or outpatient (45%), hospital inpatient (34%), home/other (16%), nursing home (3%), emergency department (2%).  Colorectal and lung cancer patients were the most likely to receive hospice care (46% and 45% respectively), breast cancer patients having the highest proportion who die in an inpatient setting without hospice (41%), and prostate cancer having the highest proportion who die at home (33%) and who die in the emergency department (7%). CONCLUSIONS: It is feasible to develop and measure end-of-life services using a claims-registry linked database and multi-stakeholder input.  These analyses demonstrate a variety of both desirable and potentially unnecessary care.  The results may be helpful in identifying areas for intervention to improve patient care.