WIHI: Medicare Reimbursement and Meaningful Conversations about End-of-Life Care

Date: November 19, 2015


  • Kate Lally, MD, FACP, Director of Palliative Care, Care New England; Hospice Medical Director, VNA of Care New England; Clinical Assistant Professor of Medicine, Alpert Medical School of Brown University
  • Harriet Warshaw, Executive Director, The Conversation Project
  • Holly Oh, MD, Chief Medical Officer, The Dimock Center
  • Jocelyn Moore, Managing Director, The Glover Park Group

On October 30, the US Centers for Medicare & Medicaid Services (CMS) announced that, starting January 1, CMS will reimburse physicians and other practitioners for talking with any Medicare recipient about their health care preferences at the end of life – also known as advance care planning. Caught up in a political maelstrom several years ago, CMS has now caught up with a growing desire of patients and loved ones to express, and have health care respect, their wishes. Talking with a trusted provider, before one is faced with a terminal illness, can be an important part of the process.

The good news is that more people today appreciate the need to articulate their preferences regarding end-of-life care. We know this from surveys and our own experiences, and because multiple initiatives, including Respecting Choices and The Conversation Project (TCP), have tapped into a groundswell of interest in tools and resources to conduct discussions about end-of-life care wherever they can occur… around the kitchen table, at family gatherings, at community centers, and in the workplace. The next frontier is for health care to reliably “receive, record, and respect” everyone’s stated wishes.

Will the new CMS payment options make advance care discussions more likely and encourage health professionals to gain the necessary skills? That’s certainly the hope, and we sorted through the latest developments on this WIHI.


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