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Proposed House Bill Supports Advance Care Planning Counseling

The Personalize Your Care Act of 2016 will provide more Medicare support for advance care planning discussions, and promote patient satisfaction at the end of life.

By Sara Heath

A new House bill, introduced earlier this week, will work to improve patient satisfaction with end-of-life care through better federal support for advance care planning, a press release says.

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The Personalize Your Care Act of 2016, sponsored by Tennessee Congressman Phil Roe and Oregon Congressman Earl Blumenauer, seeks to boost the prevalence of advance care planning and encourage more providers to have end-of-life discussions with their seriously ill patients.

At the start of this year, Medicare began reimbursing providers for conducting advance care planning discussions, ideally encouraging more of those talks to take place. A May survey, however, showed that only 29 percent of providers have taken advantage of that policy and discussed end-of-life care and advance directives with their patients.

If passed, this bill will increase public awareness of Medicare reimbursements for advance care planning counseling, and will allocate additional Medicare coverage for Advanced Illness Management and Choices Demonstration.

"Medicare providers are now being reimbursed for having thoughtful and thorough conversations with patients and their families about end-of-life choices. Our legislation builds on what we've accomplished to further ensure patients' wishes for care are understood, respected, and enforced," Congressman Blumenauer explained.

The bill may also create policies requiring advanced directives be stored in EHRs, making them easy to update and available to any treating physician.

Ensuring advance care planning discussions occur is an integral part of patient satisfaction and patient-centered care, the bill’s sponsors say. By discussing patient wishes toward the end of life, providers can make sure they honor a patient’s dignity and securing the comfort of the patient’s family and caregivers.

"Conversations about end-of-life care can be difficult, but it's extremely important for patients and their families to make these decisions with their medical providers," said Congressman Roe.

"I've been on both sides of these discussions – as a physician and a family member – and I know firsthand the peace of mind that comes with knowing a patient or loved one's wishes,” he continued. “This bill will ensure patients, families and medical professionals have the resources and tools they need to navigate these sensitive but necessary conversations, and I am proud to partner with Congressman Blumenauer on this legislation."

The bill is receiving support from industry groups, including the National Hospice and Palliative Care Organization (NHPCO). NHPCO president and CEO J. Donald Schumacher says the Personalize Your Care Act will help ensure the patient satisfaction that the organization advocates in end-of-life care.

"The National Hospice and Palliative Care Organization enthusiastically supports the Personalize Your Care Act of 2016 and applauds the leadership of Representatives Blumenauer and Roe," he said.

"Self-determination is at the core of the hospice philosophy and care model, and we believe that the Personalize Your Care Act will allow some of our most vulnerable patients to have information and support they need to make healthcare decisions."

Despite the fact that several industry experts, such as Schumacher, advocate for advance care planning discussions, those talks do not happen as frequently as desired.

According to a report from the John A. Hartford Foundation, advance care planning discussions often fall by the wayside because they are a difficult task for providers to tackle.

Just under half of patients surveyed in the report state that they do not engage in advance care planning talks because they are uncomfortable with the topic and do not know how to approach it with their patients.

Several others say that they do not know the best time to broach the subject with their patients. Forty-eight percent of providers don’t want their patients to think they are giving up on them, and 46 percent don’t want their patients to give up hope.

Regardless of these apprehensions, it is important that providers discuss end-of-life plans with their critically ill patients. By recording patient’s wishes and making sure that all treating providers have the means to fulfill them, healthcare professionals can help improve patient and family satisfaction with care, and ensure a patient’s dignity in the end of their lives.

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