Medicare to cover end-of-life counseling

In a news release the Centers for Medicare and Medicaid Services said the proposal follows a recommendation by the American Medical Association to pay doctors “to make advance care planning services” a reimbursement. On Wednesday, officials with the federal program announced this change, claiming that doctors will now be reimbursed for their conversations with patients on end-of-life care options.

Efforts to support end-of-life planning were derailed in 2009 during the debate over the Affordable Care Act.

End-of-life discussions shouldn’t be regarded as taboo.

It suggests that what many doctors view as a common-sense option is no longer seen by the Obama administration as politically toxic.

“The rumor that’s been circulating a lot lately is this idea that somehow the House of Representatives voted for “death panels” that will basically pull the plug on grandma… this arose out of a provision in one of the House bills that allowed Medicare to reimburse people for consultations about end-of-life care, setting up living wills, the availability of hospice, etc”.

“Establishing separate payment for advance care planning codes provides beneficiaries and practitioners greater opportunity and flexibility to utilize these planning sessions at the most appropriate time for patients and their families”, the Centers for Medicare and Medicaid Services wrote.

“So the intention of Congress was to give people more information so that they could handle issues of end-of-life care when they’re ready, on their own terms”. Opponents declared the conversations a step toward “death panels” that would have the government ration care for the elderly and infirm. Though they are not pleasant, they are necessary, Patrick Conway, Medicare’s CMO said. Mack, the lead author, said decisions about treating teens and young adults are challenging because they are at a different stage of life; some may have young children and want to extend life as long as possible. “This issue has been mischaracterized in the past and it is time to facilitate patient choices about advance care planning decisions”. A 2014 report from the influential Institute of Medicine, which cited the “death panel” myth as a hurdle to reforming a deeply flawed system for end-of-life care, also endorsed paying physicians for these conversations.

This is a welcome proposal, and reflects a growing recognition among Americans that the health system too easily goes on autopilot, undertaking invasive procedures that often do little to improve the quality of a patient’s life. “Beginning Medicare is one of those times, since it can be a point of awareness and reflection”. “We are pleased that CMS recognizes the value of these meaningful discussions between physicians and their patients”.