If insurers pay doctors to discuss death and end-of-life care with their patients, this may significantly reduce unnecessary spending and lower healthcare costs, according to a recent report from the Institute of Medicine.
End-of-life care, particularly palliative care, can improve outcomes and reduce costs by decreasing hospitalizations and lessening use of acute care services. In fact, a 2011 study found that patient directives that limit end-of-life treatment saves almost $5,600 per death, Reuters reported.
However, the IOM said an increase of incentives can motivate doctors to offer the services. That's why the report seeks to "help normalize the advance care planning process by starting it early, to identify a healthcare agent and to obtain guidance in the event of a rare catastrophic event."
It also urged both government and private insurers to cover palliative care programs for patients with advanced serious illnesses. Included is high-quality, patient-centered care that's provided by qualified and trained medical professionals.
The IOM specifically said insurance coverage of palliative care should provide financial incentives for:
- Medical and social support services that decrease emergency room and acute care services utilization,
- Coordinated care across settings and providers, including hospitals, ambulatory settings and home and community locations and
- Improved shared decision making and advance care planning.
Some insurers have already taken steps to implement widespread coverage for end-of-life care. For example, Cambia Health, which owns Regence Blue Cross Blue Shield, created a palliative care program that expands benefits to include coverage of home health aids and in-home counseling for people who are eligible for palliative care.
"We know we want to include the behavioral health piece in addition to the medical piece, because this is a very difficult time in the life of patients and their families," Torrie Fields, Cambia's program director for serious illness and palliative care told FierceHealthPayer in an exclusive interview.