Providers applaud CMS proposal to cover advance care planning

Long-term care organizations are applauding a proposal released by the Centers for Medicare & Medicaid Services that would reimburse healthcare practitioners for discussing advance care planning with patients.

AMDA — The Society for Post-Acute and Long-Term Care Medicine released a statement supporting the proposed ACP reimbursement, noting how it's a “necessary and important” part of providing long-term care.

“Post-acute and long-term care practitioners provide quality and thoughtful care and family members and friends of very ill patients will receive greater peace of mind that the care their loved ones receive is based on adequate medical information, collaborative goal setting, as well as respect for personal wishes and values in order to maximize comfort and quality of life,” wrote AMDA President Naushira Pandya, M.D, in the statement.

The American Medical Association also voiced its support for the proposal in a statement written by President-elect Andrew Gurman, M.D.

“This is a patient-centered policy intended to support a careful planning process that is assisted by a physician or other qualified healthcare professional,” Gurman wrote. “This issue has been mischaracterized in the past and it is time to facilitate patient choices about advance care planning decisions.”

CMS seeks comment on ACP reimbursement as part of the 2016 proposed physician fee schedule rule, released Wednesday. The proposal would cover ACP discussions between Medicare beneficiaries and their practitioners about the type of care that would be right for them, in the event that an illness leaves them unable to speak for themselves.

The 2015 physician final rule includes two codes for practitioners to document ACP discussions with their patients, although neither include reimbursement. CMS will accept public comments on the ACP proposal until September 8, according to a fact sheet.

“I think it's great news that Medicare, the major payer for healthcare in the U.S., is now formally recognizing that advance care planning is worthy of its attention and reimbursement and that in fact is a way to restore power and control to patients,” Center to Advance Palliative Care Director Diane Meier, M.D., told The New York Times.

Meier suggests that in the final rule, CMS should identify and require practitioners to document specific components of end-of-life discussions, rather than have one catch-all “checkbox” to show that an ACP conversation has taken place.