Medicare may reimburse docs for end-of-life care

AMA set to release reimbursement recommendations

The federal government could begin reimbursing physicians for speaking with Medicare beneficiaries about palliative care planning, including living wills and options for end-of-life treatment, Michael Ollove reports for Pew/Stateline.

The issue of end-of-life care came up during the federal health reform law debate in 2009, but opponents of the overhaul mischaracterized a provision that would have reimbursed physicians for end-of-life care consultations as "death panels." The provision ultimately was left out of the final reform law.

Most hospitals now offer patients palliative care

The latest effort to secure physician reimbursements for end-of-life planning is being led by the American Medical Association (AMA).

AMA to make push for end-of-life care payments

Last year, the Illinois State Medical Society (ISMS) called on AMA to issue specific medical codes for such reimbursements, noting that without the code many providers have had to "squeeze" conversations about palliative care into appointments for another purpose. Christopher Jones—a professor of palliative care at Duke University—says, "You essentially have to be deceitful to get paid to do advance care planning for the patient who doesn't have a medical illness."

Most physicians do not want intense care near the end of life

Currently, two states—Colorado and Oregon—reimburse physicians for advanced care planning. In Colorado, for example, physicians can be compensated up to $80 for a 30-minute consultation.

Responding to the push from the ISMS, AMA later this year is expected to release recommendations on what doctors should be paid for discussing palliative care options with patients.

While CMS and private insurance companies are not required to follow the organization's recommendations, they often do. And hospital groups say that if CMS approves AMA's recommendations, physicians will be more likely to discuss advanced care planning with patients.

Physicians want to expand end-of-life care

Meanwhile, Rep. Earl Blumenauer (D-Ore.) is sponsoring a bill that would ensure reimbursement for palliative care planning (Ollove, Pew/Stateline/USA Today, 6/2).


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