American Nurses Association Commends Inclusion of End-of-Life Consultation In Proposed Medicare Payment Rule (7/9/15)

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July 9, 2015

Adam Sachs, 301-628-5034
Jemarion Jones, 301-628-5198

American Nurses Association Commends Inclusion of End-of-Life Consultation
In Proposed Medicare Payment Rule
Rule Would Focus on Preferences of Patients in End-of-Life Situations

SILVER SPRING, MD – The American Nurses Association (ANA) applauds the Centers for Medicare and Medicaid Services (CMS) for including the advance care planning codes in the recently released 2016 Medicare Physician Fee Schedule. Through this action, CMS recognizes that advanced care planning services, commonly referred to as “end-of-life” consultations, are essential to delivering high-quality care in a manner that fully aligns with the goals and desires of the patient. This proposal, if finalized, will help ensure that patient care preferences are understood by health care providers, and that patients receive their preferred care when facing complex, serious health care issues.

Advance care planning consultations focus on patient preferences and are voluntary on the part of the patient. Research has shown the importance of advance care planning in achieving results such as better care, higher patient and family satisfaction, fewer unwanted hospitalizations, and lower rates of caregiver distress and depression. Advance care planning is a particularly important tool for Medicare beneficiaries with multiple chronic illnesses and for the family members and other caregivers involved with making medical decisions and providing care.

Advance care planning service codes are proposed for physicians and other qualified health professionals. ANA urges CMS to specify that advanced practice registered nurses (nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, and certified nurse-midwives) are included in payment models for advance care planning services.

The value of advance care planning has been widely recognized. The Centers for Disease Control and Prevention has acknowledged the importance of the service, and the 2014 Institute of Medicine (IOM) report “Dying in America” highlighted the importance of honoring individual preferences. This IOM report included payment for advance care planning as a key recommendation.

ANA was one of 65 organizations that signed a letter highlighting the importance of advance care planning and urging CMS to include payment codes for the services in the Medicare Physician Fee Schedule. This coalition of organizations, representing patients, health care professionals, caregivers, faith-based health care systems, and many other health care advocates, urged CMS to take this important step to improve care for Medicare beneficiaries. ANA joins with these groups in thanking CMS for including advance care planning codes in this proposed rule.

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ANA is the only full-service professional organization representing the interests of the nation's 3.4 million registered nurses through its constituent and state nurses associations and its organizational affiliates. ANA advances the nursing profession by fostering high standards of nursing practice, promoting the rights of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Congress and regulatory agencies on health care issues affecting nurses and the public.