Opening the Door to Advance Care Planning Conversations

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Karen Utterback By Karen Utterback 
Former Vice President, Product Marketing and Strategy, McKesson (Retired)
A doctor discussing advance care planning with female patient

The American Medical Association (AMA) is, understandably, quite happy about Medicare’s proposed plan to cover advance care planning in the 2016 Medicare Physician Fee Schedule. “This issue has been mischaracterized in the past, and it is time to facilitate patient choices about advance-care planning decisions,” said Dr. Andrew Gurman, AMA’s president-elect.

The proposed rule affirms the need to support patient/physician conversations, Gurman continued. “This is a patient-centered policy intended to support a careful planning process that is assisted by a physician or other qualified health care professional.”

I couldn’t agree more, and I’d add that it’s a terrific opportunity for home care organizations, which are uniquely positioned to help physicians in this area.

In an interview with FiercePracticeManagement, Dr. Phillip Rodgers of the American Academy of Palliative and Hospice Medicine said end-of-life discussions improve quality of care and life for seniors and are widely supported by the majority of physicians, patient organizations and payers in the US. Research from the American Society of Clinical Oncology and the Institute of Medicine back up his claims.

Nevertheless, advance care planning conversations require a skillset not all physicians have acquired. In March, Dr. Atul Gawande told an audience at Stanford Medical School that “doctors tend to be ‘explain-aholics’ and rarely take the time to ask their patients about their values and priorities for the time they have left.”

And Dr. Diane Meier, director of the Center to Advance Palliative Care, told the New York Times that although she thinks Medicare’s recognition of end-of-life-planning is a huge step forward, it’s not enough to just pay for it. “You have to make sure people know what they’re doing and are well-trained,” she said.

As experts in senior care and, often, hospice and palliative care, home health and hospice organizations can view this proposal as an ideal opportunity to share their experiences, training and resources with not only their referral partners, but all the physicians in their community.

To help you start the conversation with your patients and their families, check out this blog post about end-of-life care discussions.

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