Health care experts have long wanted doctors to talk to their patients about death. Starting this year, the federal government will pay doctors to do it.
That’s thanks to a Jan. 1 change to the Medicare program that will reimburse physicians for having advance care planning conversations with elderly patients, crafting a personal guidebook of sorts for a doctor to know just how aggressively (or minimally) a patient would like to be treated.
Advocates have been pushing the concept for years. Yet, looking forward, some hope this will lead to even more changes down the road, such as a method of standardization, interoperability of electronic health records, and training on these conversations for every medical student.
“It's a signal,” said Diane Meier, director of the Center to Advance Palliative Care. “This decision by [the Centers for Medicare and Medicaid Services] to enable clinicians to be able to be paid for having these conversations is a kind of social signal that the government thinks that doctor-patient communication is important enough to pay for it.”
The CMS rule finalized in 2015 had found a staunch advocate in Democratic Rep. Earl Blumenauer of Oregon, who says he often brought the issue up around high-ranking administration officials. He introduced a bill on the subject year after year—after former Alaska Gov. Sarah Palin said the proposal amounted to setting up “death panels” during the Affordable Care Act debate. Her comments started an uproar, and the language wasn’t in the bill that made it to President Obama’s desk.