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Written by: Laura T | Plan Beyond
Hooray! The answer to this is finally…almost. If that sounds like an unfulfilling answer, it’s a heck of a lot further than we’ve gotten before.
Remember “ death panels ?” When the Affordable Care Act (a.k.a. Obamacare) was discussed in 2009, there was an attempt to include end-of-life conversations as part of the coverage. Death panels were the unfortunate name given to made-up insurance, hospital, and doctor panels that were expected to withhold medical care from older American under the affordable care act.
Was it a political ploy by those that opposed the Affordable Care Act? Sure. But did it tap into a very real concern about the health and wellbeing of older Americans? Absolutely. As a result, including end-of-life conversations as part of the Affordable Care Act and Medicare in general got put on the back burner.
The thing is, older Americans continue to consume large volumes of healthcare. In fact, a recent report showed that 40% of all Medicare expenses cover care for people in the last month of their life, and 10% of Medicare patients represent 70% of all Medicare spending. What this really means: older Americans are spending a lot of money on end-of-life care.
This trend is not about to end any time soon. A recent report by the Kaiser Family Foundation found that nearly 50 million Americans are on Medicare. So those stats we just mentioned are only going to get worse as Boomers continue to age.
It’s under this umbrella that Medicare is stepping up to the plate and talking about compensating doctors for having end-of-life conversations. Doctors would be paid for the time they spend discussing living wills , healthcare proxies , POLST forms , palliative and hospice care , and of course how patients want to spend the last days of their lives. It in no way impacts which decisions patients have to make. It merely gives patients the time to speak with their doctors about what options are out there. In a nutshell, it lets patients actually learn what options they have.
In a recent interview J. Donald Schumacher, president of the National Hospice and Palliative Care Organization, noted, “Patients deserve assistance with advance care planning and it’s essential that these conversations take place before a crisis happens. We are pleased that [Medicare] recognizes the value of these meaningful discussions between physicians and their patients.”
There is still a hitch.
Exactly what types of conversations will be covered is still undefined. There also hasn’t been any mention of how much doctors will be compensated for these conversations versus other procedures they must perform. A final proposal is expected by November.
In spite of this uncertainty, this is a win. When doctors can be paid for having these conversations it makes it much more likely they will happen. And when these conversations happen patients and their families will have better peace of mind during those difficult end-of-life decisions.