The Henry J. Kaiser Family Foundation recently wrote an informational and insightful article explaining Medicare’s role in end of life care plans. About three-quarters of the 2.5 million people who die during the year in the US are ages 65 and older, making Medicare the largest insurer of health care provided during the last year of life. This statistic was relayed by Centers for Disease Control and Prevention, “Deaths: Final Data for 2010,” National Vital Statistics Report 2013;61(4), Table 3. As the baby boomer generation continues to age, this issue increases in importance.
Here are some of the highlights from this article to consider for yourself and your family members. Public comments are welcome through 8 September, 2015 to CMS about their proposed regulatory changes.
CMS is proposing that Medicare begin paying physicians and other qualified health care professionals for advance care plan discussions. Specifically, in a proposed regulation released July 8, 2015, CMS introduced two new billing codes—previously recommended by the American Medical Association—for advance care planning provided to Medicare beneficiaries.
These new billing codes would be available to physicians and other qualified health professionals starting January 1, 2016. CMS is seeking public comment on these proposed regulations through September 8, 2015. A final determination is expected in the Fall of 2015, with CMS’s release of the final rule for the 2016 Medicare physician fee schedule.
“Medicare covers a comprehensive set of health care services that beneficiaries are eligible to receive up until their death. These services include care in hospitals and several other settings, home health care, physician services, diagnostic tests, and prescription drug coverage through a separate Medicare benefit. Many of these Medicare-covered services may be used for either curative or palliative (symptom relief) purposes, or both. Medicare beneficiaries with a terminal illness are eligible for the Medicare hospice benefit that includes additional services—not otherwise covered under traditional Medicare—such as bereavement services.
Advance care planning involves multiple steps designed to help individuals a) learn about the health care options that are available for end-of-life care; b) determine which types of care best fit their personal wishes; and c) share their wishes with family, friends, and their physicians. In some cases, patients who have already considered their options may need only one advance care planning conversation with their physician. Under current law and regulation, Medicare only covers advance care planning under limited circumstances.
Previously, the agency that runs Medicare—the Centers for Medicare and Medicaid Services (CMS)—included advance care planning as a voluntary part of the ACA-established annual wellness visit in Medicare, but retracted this provision before it could take effect in January of 2011.”
Having end of life planning conversations and clarifying your wishes in Health Care Advance Directives before an emergency, provides relief to loved ones and allows health care providers the ability to act quickly while taking into consideration an individual’s wishes. Be proactive. Be informed. Take care of this vital piece of business for yourself and your loved ones.
What other resources would make you day to day living easier? Let us know. Our aim is to make sure you have resources to help you and your families today and into the future.
Thanks for being a part of the community.
-Lynn