WCOE: Paying Doctors to Talk About End-of-Life Care

In The New York Times article, “Coverage for End-of-Life Talks Gaining Ground,” Pam Belluck writes about efforts to reimburse physicians for having difficult but critically important discussions with patients about the kind of care they wish to receive at the end of life. “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 may be covered for the 50 million Americans on Medicare as early as next year,” Belluck writes.

Belluck reports that some private insurers have begun reimbursing for advanced care planning, and the American Medical Association has recommended that the Centers for Medicare and Medicaid Services (CMS) adopt a billing code for end-of-life conversations. Additionally, there are two bipartisan bills in Congress to address end-of-life planning.

The “death panels” misnomer did a disservice to patients and their families, in particular cancer patients, for whom end-of-life issues can be more pressing and immediate. While some have argued that advanced care planning will pressure patients to reject life-saving treatment, doctors have a different view.

“Honestly, sometimes I’m making an argument that treatment is not as bad as you think because of our ability to mitigate side effects,” said Dr. Thomas Gribbin, an oncologist from Michigan who encouraged two Michigan insurers to cover end-of-life conversations.