Change without Change? Assessing Medicare Reimbursement for Advance Care Planning
Change without Change? Assessing Medicare Reimbursement for Advance Care Planning
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DOI：
10.1002/hast.848
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发表时间：
2018-05-01
影响因子：
3.3
通讯作者：
Wright, Megan S.
中科院分区：
文献类型：
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作者：
Wright, Megan S.
2016 年 1 月，Medicare 开始补偿临床医生与患者或患者代理人进行预先护理计划所花费的时间。此类计划涉及讨论个人希望接受的护理，如果他或她有一天失去了做出医疗保健决定的能力或与代理人就临终愿望等问题进行对话。临床医生可以因面对面解释和讨论护理和预先指示以及填写预先护理计划表而获得报销。尽管此类计划报销的政治障碍似乎已基本消除，但医疗保险政策对提供者计费实践的影响似乎有限，这表明临床医生参与预先护理计划存在其他障碍。此外，该政策对患者行为和临床医患关系的影响尚不清楚。
In January 2016, Medicare began reimbursing clinicians for time spent engaging in advance care planning with their patients or patients’ surrogates. Such planning involves discussions of the care an individual would want to receive should he or she one day lose the capacity to make health care decisions or have conversations with a surrogate about, for example, end‐of‐life wishes. Clinicians can be reimbursed for face‐to‐face explanation and discussion of care and advance directives and for the completion of advance care planning forms. Although it seems that political barriers to reimbursement for such planning have largely faded, the Medicare policy's impact on provider billing practices appears to be limited, suggesting other barriers to clinician engagement in advance care planning. Additionally, the effects of this policy on patient behavior and the clinician‐patient relationship are not yet known.