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Hospice community is disappointed with administration's decision PDF Print E-mail
Written by Holyoke Enterprise   

“We are surprised that the administration has decided to reverse the decision to include voluntary advance care planning consultations as part of a Medicare beneficiaries’ annual wellness exam,” remarked J. Donald Schumacher, president and CEO of the National Hospice and Palliative Care Organization (NHPCO).

Despite this action, NHPCO strongly encourages all Americans to think about their wishes for care at the end of life and engage in advance care planning.

This includes having discussions with health care providers and family members, completing an advance directive (which includes a living will and health care proxy), and making sure their loved ones understand their wishes.

“Frankly, we are somewhat disappointed that the regulatory guideline making this part of the annual Medicare exam and compensating the physician for taking time to talk about personal preferences has become such a political issue,” continued Schumacher.

“It’s simply about educating patients about the types of decisions they might need to consider in future health care situations and then supporting them as they make their own choices based on their values, beliefs and preferences.”

The opportunity for this voluntary consultation with a physician has been part of the “welcome to Medicare” exam since 2008. Research has shown that patients who discuss their care options when facing a serious or life-limiting illness report a higher quality of life, less hospitalizations and fewer visits to the emergency department. Family caregivers have also been shown to benefit from discussions held between physicians and patients.

Far too often, patients and their families are forced to make decisions in times of crisis; these voluntary advance care planning consultations would have facilitated informed conversations prior to the onset of an illness or medical crisis.

“Death and dying can be a difficult topic for people to deal with—this includes politicians crafting legislation, health care providers caring for patients and people who may be confronting a serious illness. But as hard as this can be, it’s far more difficult for a patient and family to face a medical crisis without a prior understanding of an individual’s wishes and how quality of life might be addressed.

“Knowing a loved one has engaged in discussions with a knowledgeable physician can bring comfort to patients and families—and that can be quite a gift at a challenging time,” Schumacher said.

“Having this option spelled out in Medicare regulations would have raised awareness of advance care planning and potentially opened the door for valuable conversations.”

NHPCO emphasizes advance care planning is not about discontinuing treatment, saving money or having someone else make decisions; it’s about making sure wishes are known and then honored, regardless of whether people choose every medical intervention available, discontinue non-productive treatments or something in between.

There is concern among hospice providers that the debate about this regulation and last year’s “death panel” rumors will cause additional confusion to members of the public and make them even more suspicious of advance care planning.

Hospice and palliative care providers are skilled in helping people understand issues of importance when facing a serious or life-limiting illness and can be important resources for those looking to learn more or make their wishes known.

NHPCO’s Caring Connections offers information on care at the end of life and provides free, state-specific living will and health care proxy forms. Visit or call the HelpLine at 1-800-658-8898.

Locally, people may contact Hospice of the Plains for Advance Care Planning literature.

People may call the Sterling office at 970-526-7901 or the Wray office at 970-332-4116 to request information or to arrange a program regarding End-of-Life Planning for a group, church, club, organization or business.