Great news: Medicare may soon pay doctors to have ‘end of life’ discussions with patients

Great news: Medicare may soon pay doctors to have ‘end of life’ discussions with patients

[Ed – NYT fudges what the “death panels” argument was really about.  “Death panels” actually have nothing to do with “end of life” discussions.  The “death panels’ characterization is about the Independent Payment Advisory Board – IPAB – which will decide where to make the cut on Obamacare compensation for corrective and medical procedures.  It’s the board that will decide Granny is too old for a hip replacement and must therefore face years of immobilized decline.]

Five years after it exploded into a political conflagration over “death panels,” the issue of paying doctors to talk to patients about end-of-life care is making a comeback, and such sessions may be covered for the 50 million Americans on Medicare as early as next year.

Bypassing the political process, private insurers have begun reimbursing doctors for these “advance care planning” conversations as interest in them rises along with the number of aging Americans.  …

Some states, including Colorado and Oregon, recently began covering the sessions for Medicaid patients.

But far more significant, Medicare may begin covering end-of-life discussions next year if it approves a recent request from the American Medical Association, the country’s largest association of physicians and medical students. One of the A.M.A.’s roles is to create billing codes for medical services, codes used by doctors, hospitals and insurers. It recently created codes for end-of-life conversations and submitted them to Medicare.

The Centers for Medicare and Medicaid Services, which runs Medicare, would not discuss whether it will agree to cover end-of-life discussions; its decision is expected this fall. But the agency often adopts A.M.A. recommendations, which are developed in meetings attended by its representatives. And the political environment is less toxic than it was when the “death panel” label was coined; although there are still opponents, there are more proponents, including Republican politicians. …

Now, some doctors conduct such conversations for free or shoehorn them into other medical visits. Dr. Joseph Hinterberger, a family physician here in Dundee, wants to avoid situations in which he has had to decide for incapacitated patients who had no family or stated preferences. …

With reimbursement, “I’d do one of these a day,” said Dr. Hinterberger …

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