Medicare Proposes Paying for Advance Care Planning

Have you ever wondered about all those codes you see on a bill or chart at your healthcare provider’s office?  If you’re covered by Medicare—the nation’s largest insurer dedicated exclusively to helping older people with their health expenses—chances are they’re part of a payment system known as the physician fee schedule.  Medicare pays eligible providers for their services based on the codes they use to bill for the patient visit.

Each year, experts from the Centers for Medicare & Medicaid Services (CMS) review, refine, and tweak the types of services included in the physician fee schedule to make it more responsive to patient needs and professional advice. The proposed schedule for 2016 was just released this week, and it’s got some important new updates that will benefit older Americans.  In particular, CMS is now proposing covering advance care planning (ACP), which would offer patients an important outlet for talking with healthcare providers about their long-term needs and expectations.  Many people have questions about what ACP is and how it works, and the infographic below from the American Geriatrics Society is a helpful guide to the basics when it comes to this important new service.

ACP Infographic_07 06 15

Interested in learning more or taking action?  Consider sharing this post or some of the ACP-related resources posted by the Health in Aging Foundation to Twitter (@HealthinAging) and Facebook (Facebook.com/HealthinAging).  You can also submit a comment of support to CMS to let them know you value ACP as part of your care.

2 thoughts on “Medicare Proposes Paying for Advance Care Planning

  1. This is information is so important for so many. Unfortunately, in my practice, increasingly I am encountering elderly patients with dementia and no family or health care proxy. This is a most unfortunate situation as the default scenario often results in invasive and aggressive life-sustaining care that may be inappropriate. What are your thoughts about assigning resuscitation status for those that cannot make it for themselves or assigning guardian ad litem or health care proxies to do it for them?

  2. It is difficult to legally assign a status without a proxy spokesperson, even though we have the patient’s best interest in our hearts. I usually ask for the person listed by the state as the proxy who would have the right to speak when there is no legal designee (every state has a list–in Florida, for example, the order is the spouse, adult children, parent, sibling, close friend, social worker, found at http://www.flsenate.gov/Laws/Statutes/2012/765.401). There usually is still some close friend around or a social worker. If not, I go ahead and refer to adult protective services to initiate the guardianship process.

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