DUNDEE, N.Y. - 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 might be covered for the 50 million Americans on Medicare by next year.
DUNDEE, N.Y. — 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 might be covered for the 50 million Americans on Medicare by 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.
People are living longer with illnesses, and many want more input into how they will spend their final days, including whether they want to die at home or in the hospital, and whether they want full-fledged life-sustaining treatment, just pain relief or something in between.
Some states 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 AMA’s roles is to create billing codes for medical services, codes used by doctors, hospitals and insurers. It has 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 AMA recommendations. 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 GOP politicians.
If Medicare adopts the change, its decision would also set the standard for private insurers, encouraging many more doctors to engage in these conversations.
“We think it’s really important to incentivize this kind of care,” said Dr. Barbara Levy, chairwoman of the AMA committee that submits reimbursement recommendations to Medicare.
Some doctors conduct such conversations free.
Dr. Joseph Hinterberger, a family physician in Dundee, N.Y., wants to avoid situations in which he must decide for incapacitated patients who have no family or stated preferences.
With reimbursement, “I’d do one of these a day,” Hinterberger said.