End of life care refers to the treatment of patients in the final hours or days of their lives, as well as the health care of all those with a terminal illness or a terminal condition that has become advanced, progressive and incurable.
A national panel recently appointed by the Institute of Medicine, the research branch of the National Academy of Sciences, released a report on September 17, 2014. The report stated that the United States’ system for handling end-of-life care is largely inept, thus necessitating a major makeover.
The report was authored by a 21-member nonpartisan committee comprised of doctors, nurses, insurers, religious leaders, lawyers and experts on aging. It called for major overhauls in the industry, and noted that many of its recommendations could be accomplished without the necessity of the often slow-moving legislative process.
The 507- page report called for a “major reorientation and restructuring of Medicare, Medicaid and other health care delivery programs,” as well as the elimination of financial incentives that are alleged to encourage expensive hospital procedures over low-tech services like home health care and pain management, particularly for sick and elderly patients.
One of the reports suggestions called for insurers to reimburse health care providers for conversations with patients on advance care planning.
Advance care planning involves learning about the types of decisions that might need to be made, considering those decisions ahead of time, and then letting others know about your preferences, often by putting those decisions into advanced directives (a legal document that goes into effect only if you are incapacitated and unable to speak for yourself).
On the same note, the committee’s report also proposed that insurers and Medicare alike should create financial incentives to encourage physicians to have continuing conversations with patients on advance care planning, possibly starting as early as a patients teenage years.
More promisingly, Medicare, which covers a robust amount of Americans and whose members account for an estimated 80 percent of deaths each year, is considering implementing such a program.
Additionally, the report also recommended changing the reimbursement structure so that Medicare would pay for home health services instead of championing hospital care. However, significantly altering Medicaid so that it would provide better coverage of long-term care for the elderly would require congressional action.
While the committee’s expertise will surely carry great weight in the health care industry, immediate change is unlikely and for many sick elderly, time is not an option. There may, however, be a number legal options available to help seniors narrow down their end of life planning. For more information about your legal options, contact our elder law attorneys at the Law Office of Tanya Hobson-Williams P.C.
