On Jan. 1, a truly profound health care policy will take effect. After years of politicians throwing around terms like "death panels" in the federal health care conversation, America will finally reimburse health care providers for doctor-patient conversations about end-of-life options, which are also commonly referred to as advanced care planning.
Medicare already pays for some of these conversations, but starting next month, this option will be available to any patient, whenever they feel end-of-life planning is necessary.
When it comes to end-of-life care, the healthcare system has been dangerously skewed for too long.
Previously, the hourly revenue generated by a doctor discussing end-of-life care was $87. That was the value we placed on a physician conducting a cognitive service, or a service that involves reasoning and judgment without a procedure.
The same physician, however, can make over $300 an hour by performing a colonoscopy or cataract extraction instead. Because of this difference, physicians were not necessarily encouraged to spend time providing cognitive services, nor were they rewarded for doing so.
At a time when people with chronic illnesses are living longer than ever, providing an incentive for doctors to order procedure after procedure instead of having an honest conversation with terminally ill patients is unacceptable.
For far too long, the intimate and vital doctor-patient conversation regarding end-of-life care was simply not valued by our country’s healthcare system. Everyone deserves the opportunity to discuss their options as they approach the end of their life—and they deserve doctors that have ample time to discuss their options with them.
I can understand on some levels why the complexity of end-of-life care is so hard to place a value on. Medical procedures are quantifiable and measurable practices that doctors learn in medical school and residency, and then apply to their patients. They come with an automatic price tag based off time, equipment and difficulty level.
The discussions revolving around end-of-life care are equally complex, but cannot be as easily quantified, reduced or priced due to their intimate and multifaceted nature.
As of Jan. 1, healthcare professionals will be able to bill Medicare approximately $80 for the first half hour of end-of-life planning, and $75 for an additional half hour. This acknowledgement of the importance of end-of-life planning shows a shift in thought for healthcare professionals, policymakers, as well as the general public.
But how ready are doctors to help patients make decisions regarding their end-of-life care? This is a topic traditionally avoided by most medical schools, but one that is quickly being improved upon in order to keep up with the ever-changing face of healthcare.
We have probably all seen this situation play out on some level — a terminally ill loved one quickly approaches the end of their life, but family members struggle to discuss the available options, and suddenly it’s too late.
As we enter the new year, and our healthcare system places new emphasis on the importance of end-of-life planning, let’s open up the discussion on a personal level, too. Let’s stop putting off the discussion and start discussing our options.
