Medicare Proposes Paying Doctors For End-Of-Life Discussions
Six years after a similar proposal nearly derailed passage of the Affordable Care Act, the Obama administration has revived a plan to reimburse physicians for talking with Medicare patients about how patients want to be cared for as they near death.
The New York Times:
Medicare Plans To Pay Doctors For Counseling On End Of Life
Medicare, the federal program that insures 55 million older and disabled Americans, announced plans on Wednesday to reimburse doctors for conversations with patients about whether and how they would want to be kept alive if they became too sick to speak for themselves. The proposal would settle a debate that raged before the passage of the Affordable Care Act, when Sarah Palin labeled a similar plan as tantamount to setting up “death panels” that could cut off care for the sick. The new plan is expected to be approved and to take effect in January, although it will be open to public comment for 60 days. (Belluck, 7/8)
The Associated Press:
Medicare's End-Of-Life Counseling Policy May Find Acceptance
Six years ago, a proposal for Medicare to cover end-of-life counseling touched off a political uproar that threatened to stall President Barack Obama's health care law in Congress. Wednesday, when Medicare finally announced it will make the change, reaction was muted. ... But for the Obama administration, end-of-life counseling remained politically radioactive, even as the idea found broader acceptance in society. Dr. Joe Rotella, chief medical officer of the American Academy of Hospice and Palliative Medicine, called Medicare's move a "little miracle," given the "death panels" furor. He said he believes the controversy has passed. (Alonso-Zaldivar and Sedensky, 7/9)
The Wall Street Journal:
End-Of-Life Talk Proposed As New Medicare Benefit
The federal government is proposing to pay health-care providers for talking to Medicare beneficiaries about end-of-life care after mounting calls for a better approach to conversations about dying that can both save costs and improve patient care. The rule proposed Wednesday would reimburse doctors, nurse practitioners and some others in the health industry for discussions about end-of-life care, which was championed last year in a report by the Institute of Medicine, an independent advisory body. (Armour and Radnofsky, 7/8)
The Washington Post:
Medicare Proposes To Pay Doctors To Have End-Of-Life Care Discussions
The Centers for Medicare and Medicaid Services (CMS) released the new plan Wednesday as part of its annual Medicare physician payment rule. The proposed rule includes reimbursement for “advance care planning.” The final rule is due Nov. 1, and payments would start Jan. 1. The discussions would be voluntary. (Sun, 7/8)
Los Angeles Times:
Obama Administration Revives Plan Once Criticized As 'Death Panels'
The new proposal from the Department of Health and Human Services would not require Medicare patients to sign any order or even to talk with their physicians about end-of-life care. Rather, the proposed regulation would allow medical providers to bill Medicare for "advance-care planning" should a patient want to have the discussion. Such a session could include “the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed) by the physician or other qualified health professional,” according to the proposed rule. (Levey, 7/8)
Huffington Post:
Medicare Outlines End-Of-Life Planning Proposal That Will Make Sarah Palin's Head Explode
Medical societies and seniors' groups like the AARP have long supported so-called advance care planning as a way for patients to consider whether they want intensive medical care in the event of a life-threatening illness near the close of their lives, and to make their preferences known to their loved ones in writing. But Medicare has never had a mechanism with which to pay doctors for this counseling, except during a physical exam when beneficiaries first enroll in the program. (Young, 7/8)
Meanwhile, a look back at the origins of the palliative care movement -
The Kansas Health Institute News Service:
Death And Dying: Expanding Palliative Care
A milestone multi-year study published in 1995 startled the medical world when it revealed that about half the hospital doctors treating terminally ill people were unaware when their patients had not wanted aggressive, life-extending treatments and that about half those who died in their care had pain that might have been abated. Equally shocking, the report found that follow-up efforts to improve the results at the teaching hospitals involved in the study had failed. (Shields, 7/8)