End-of-life talks could become more common following Medicare payment change

Physicians may be more likely to have end-of-life talks with patients now that Medicare has started paying for advanced-care planning conversations, according to an Associated Press report published by CBS News.

Last summer, CMS included a change allowing for payment for end-of-life talks in a package of regulations. Billing was permissible as of Jan. 1. CMS has not released data indicating how many people have participated in the sessions, according to the report. However, a poll cited by the Associated Press sheds light on that number.

The poll, fielded by the California Health Care Foundation, Cambia Health Foundation and John A. Hartford Foundation, surveyed 736 physicians who see patients 65 and older. The poll found only 14 percent of respondents had already billed Medicare for the new advanced-care planning conversations, according to the report. The report notes, though, that the survey was conducted Feb. 18 through March 7, so the earliest participants only had about six weeks from the start of the benefit.

Overall, the poll found 95 percent of respondents expressed support for the Medicare benefit and a large majority considered such conversations important, according to the report.

Still, the idea of paying for advance-care planning previously stimulated fears of "death panels," after an early bill of the Affordable Care Ace included a provision to pay for voluntary end-of-life conversations. However, supporters are hopeful these doubts will not linger, according to the report.

"The more and more that that happens, the more patients, families and doctors will become comfortable with it," Joe Rotella, MD, CMO of the American Academy of Hospice and Palliative Medicine, told the Associated Press. "Any distrust people have about, 'What is this?' really disappears when patients sit down and find out this is about empowering them."


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