Just 14 percent of U.S. doctors have billed the national social insurance program Medicare, for extra time spent with patients to talk about their end-of-life wishes, according to a new report that analyzed data from more than 700 doctors from different healthcare foundations.

In January, the federal program directed to elderly adults and disabled people started paying to physicians, for talking to patients about how they will die. This new measure was supported by 95 percent of U.S. physicians.

Medicare has proposed a new rule that would allow doctors to bill for end-of-life conversations with patients. Credit: Rhode Island Public Radio.

However, just 14 percent of them have reported discussing to patients about their end-of-life wishes, according to a Reuters report. Currently, 16 percent of Americans are covered by Medicare. New Policies seek to inform people about their healthcare treatment options, in order to decide which kind of care they prefer.

The patient’s decision is written in a report and stored into the electronic health record of the patient, so it can be seen by family, friends and healthcare providers. Special conversations about end-of-life wishes can occur during a senior’s annual wellness evaluation, or during counseling sessions, said Reuters on Thursday.

At the same time, nurse and physician assistants can be reimbursed by Medicare, for planning sessions. Everyone can decide to have the conversation, even if they are not close to death.

Last year, the Kaiser Family Foundation reported that 80 percent of elderly adults were interested in talking about their end-of-life wishes. In the long term, this new measure could reduce health care costs to Medicare. According to Reuters, one-fourth of Medicare payments is directed to patients who are in their latest years of lives.

The healthcare system may not be ready for implementing this new measure countrywide

From all physicians surveyed, just 29 percent have declared evaluating end-of-life wishes among patients. At the same time, 40 percent have reported that the electronic software used to record data about patients do not include information “on advance directives”, reported Mark Miller at Reuters.

Moreover, merely 29 percent of physicians have been trained to provide end-of-life care, while 46 percent expressed that they are not sure about how to communicate with patients when having the conversation, according to a new study carried out by the John A. Hartford Foundation, the California HealthCare Foundation, and Cambia Health Foundation.

Dr. Tony Back, co-director of the Cambia Palliative Care Center of Excellence, said to Reuters that he is worried about “this big disconnect” when talking about the role of the healthcare system to understand what patients want at the end of their lives.

“If you are a patient with a serious illness, you cannot count on running into a doctor or nurse who can guide you through a conversation about what you want at the end of life.” he said to Reuters.

For instance, patients may be interested in receiving “reasonable” health care, but some would prefer to pass away in their own beds when the moment arrives, rather than in a hospital, Dr. Back explained.

“You can easily wind up in intensive care with a catheter in your bladder, intravenous lines in your arm, in a bright noisy place that will be the last moments you have on this earth,” he said, referring to people who avoid the conversation. 

Source: Reuters