Medicare could cover end of life counseling as early as Jan. 2016

Advance care planning could become a standard part of Medicare as early as January 2016, CMS announced last month as it seeks public comment on a proposal to reimburse providers who start a conversation with beneficiaries about their final wishes.

According to a statement released by CMS on July 8, “The proposal includes a number of provisions focused on person-centered care and continues the Administration’s commitment to transforming the Medicare program to a system based on quality and healthy outcomes.” Also known as end of life planning, the service being considered consists of providers ensuring an individual’s care preferences are respected in the event of a critical health situation like terminal illness. 

Find tips on how to help your clients make sure their health care preferences are respected and adapt your senior business to policy change at the end of this article. Image courtesy of iStock


Gently opening a conversation about advance care is “an important step in the right direction” for health care, Dr. Joseph Agostini writes for Aetna’s Health Section. “By making the end-of-life conversation a regular part of delivering high quality care, doctors may be more inclined to broach the subject with patients, their family members and loved ones … The policy change would also encourage physicians and their patients to talk about care preferences and plans before potentially tough and emotional decisions have to be made under the stress of a serious medical condition.”

This is the second time end of life planning has been proposed by the Obama administration. It was dismissed by conservative fixture and 2008 Republican vice presidential candidate Sarah Palin as part of political opposition to the Affordable Care Act (ACA), who likened it to a government-sponsored “death panel” in a post to her Facebook page six years ago.

Nonpartisan Kaiser Family Foundation has prepared a Frequently Asked Questions article about Medicare’s role in end of life care that goes over how end of life care responds to the sensitive nature of dying as well as the increased costs end of life care presents for the health care program. According to the FAQ, just over a third of people age 65 and older surveyed in 2013 incorrectly believed ACA established a “death panel” to make decisions on their behalf due to earlier political uproar.

The proposal has been reintroduced with language that makes it clear end of life planning affirms Medicare beneficiaries’ command over their health care (Click here to view it). It states “For Medicare beneficiaries who choose to pursue it, advance care planning is a service that includes early conversations between patients and their practitioners, both before an illness progresses and during the course of treatment, to decide on the type of care that is right for them.”

The FAQ also states beneficiaries accrue high costs in the last year of life because many of them experience multiple serious health issues at the end of their lives. According to Kaiser, “Roughly one-quarter of traditional Medicare spending for health care is for services provided to Medicare beneficiaries in their last year of life — a proportion that has remained steady for decades.” End of life planning seeks to decrease these costs for the program by making sure undesired care is not provided.

“Getting someone the right care at the right time is more likely to be of value in the long-term for everyone involved, including patients and their families,” Agostini writes about the cost-saving aspect of end of life planning.

Agents can be proactive as end of life planning receives greater recognition. Being sensitive to clients’ needs and wishes by advising them on Medicare’s changing policies is the first step — clients need to be aware of what is added to Original Medicare and what additional benefits Medicare Advantage may provide in the future. Reviewing Physician Directives, which are encouraged by all hospitals and skilled nursing facilities, is another course of action. Building a mutual relationship with a financial planner to establish a back-and-forth referral channel for clients interested in setting up or adjusting wills is a way to adapt and find new clients. Adding final expense with legacy safeguard planning to your sales portfolio is another option for helping clients make sure they are not caught unprepared.

Call RB Insurance at (800) 997 3107 or email Sales Manager Charlie Ferrell to learn more about end of life planning and Physician Directives.

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