Medicare to Pay for End of Life Discussions

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[ABSTRACT]

Advancements in medicine have dramatically expanded life expectancy in the United States. An average American born in 1900 had a life expectancy of 47 years; the same American born in 2013 can expect to live to age 78.

It is not just that we are living longer; we are dying differently. We are less likely to die suddenly or from a short illness. We are more likely to have a long period of slow decline during which time a medical system may offer interventions that extend life, but without improving its quality. Most people say they wish to die at home, but most of us will die in an institutional setting.

There is an increasing awareness of the need to start talking more about end of life treatment options for those with life limiting illnesses in the context of what we want for ourselves, and not based solely on what medical treatments are available. Thought leaders from the Institute of Medicine to Dr. Atul Gawande have spoken out about the need for physicians and patients to actively work together to create a plan of treatment that meets the informed preferences of patients.

THE NEW MEDICARE COVERAGE FOR END OF LIFE DISCUSSIONS
Medicare agrees that there is an unmet need for more discussion and education about end of life care. Starting this January, Medicare will pay physicians for holding advanced planning discussions with their patients. The physicians will receive $86 for the first half-hour discussion and another $75 for an additional half hour.

Among the common sense features of this new coverage are

A reimbursement structure that acknowledges that these discussions take time and cannot be squeezed into a 15-minute appointment.
No limits on the number of times that a patient and physician can have these end of life treatment discussions, reflecting an awareness that the decisions arising from these conversations may need to be re-evaluated as patients’ conditions change.
A modest payment structure that will prevent physicians or critics from alleging that a physician is having end of life discussions to increase income.

For what questions you should be asking as a patient see our full post at http://whiteoakcottages.com/medicare-to-pay-for-end-of-life-discussions/