The New Yorker recently published an article entitled Letting Go by Atul Gawande. It is very readable and gives a clear idea of what hospice and palliative medicine are about.

A recent article in the New York Times discussed a study by The New England Journal of Medicine regarding the positive effects of Palliative Care.

National Hospice & Palliative Care Organization provides news update regarding new benefit for Medicare Beneficiaries regarding Advanced Care Planning Consultation - See below

Medicare’s Advance Care Planning Consultation
Beginning on January 1, 2011, Medicare will reimburse physicians for holding voluntary consultations about a patient’s end-of-life wishes during annual Medicare “wellness visits.”
The Medicare guideline, issued December 3, 2010, covers advance care planning consultations and includes a discussion of setting up an advance directive that would tell doctors what to do if the patient is too ill to make medical decisions. Doctors and patients can also discuss "whether or not the physician is willing to follow the individual's wishes as expressed in an advance directive," the new guideline says.
This consultation would be voluntary, it is not required:
  • Beneficiaries could elect to have the consultation as part of the annual “wellness exam.”
  • It would be reimbursable under Medicare, just like other Medicare consultations.
The Medicare consultation gives patients information that will help them make their own informed decisions about their care:
  • Research has shown that patient discussions with their physicians results in a higher quality of life for patients and family caregivers.
  • It may cover the broad spectrum of care and options when facing a serious or life-limiting illness.
  • The consultation is with a physician—and in many cases may be the same healthcare professional the Medicare beneficiary has been seeing for years.
  • Discussing advance care planning before a beneficiary finds him or herself in a medical crisis will help ensure the patient gets the care that he or she wants.
Having Medicare cover advance care planning discussions is not really new:
  • In 2008 legislation was signed into law that allowed end-of-life planning to be part of a patient’s “welcome to Medicare” exam.
  • Healthcare reform turned the “welcome visit” into an annual “wellness visit.”
What the advance care planning consultation is NOT about:
  • It’s not about limiting or rationing care;
  • it’s not about hastening death;
  • it’s not about having choices made for the patient; and
  • it’s not about saving money.
There was much confusion surrounding a similar proposal that was part of Health Care Reform legislation debated last year. This is not a legislative proposal but a regulation that is part of Health Reform law. This exists to ensure American have the tools to make their wishes known and to assist health care providers in honoring these wishes.