Medicare Now Reimburses Doctors For End-Of-Life Discussions

May 2, 2016

A Medicare policy enacted in January of this year will help seniors decide the care they want at the end of their lives.

The policy, referenced in a Centers For Medicare and Medicaid Services (CMS) press release as “advance care planning,” for the first time establishes a separate payment and billing rate for physicians who have conversations with their patients about their wishes at the end of their lives.

By creating a separate designation, Medicare makes it more feasible for physicians to take time out of their already strapped-for-time schedules to have these conversations. Doctors can now bill $86 for a counseling session up to 30 minutes long with their patients on the care they would like to receive at the end of life.

For employers and plan sponsors, this new policy could directly benefit their Medicare-eligible retirees. More broadly, it has implications both for assuring quality of care and for controlling health care costs.

A whopping 28% of Medicare spending, estimated in 2011 to be almost $544 billion, happens in the last six months of a patient’s life. Much of that comes from measures meant to extend quantity of life, but that do not assure quality of life. Feeding tubes, breathing machines, and eleventh hour surgeries or treatments end up costing $170 billion in those last months.

While some people may still opt for these extreme measures to prolong life, everyone benefits from sitting down with their physician to have the conversation about the care they wish to receive.

To learn more about the new policy, read this article in Kaiser Health News.

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