Physicians would be paid for end-of-life conversations with their patients under proposed changes to the 2016 Medicare Physician Fee Schedule--a move that could catch on with private payers, as well.
The Centers for Medicare & Medicaid Services (CMS) also said Wednesday that it plans to modify some of its quality reporting and shared savings initiatives.
Medicare already offers advance care planning services when individuals first enroll, but the new rule would establish a separate payment system for advance care planning codes. This would offer healthcare providers and Medicare beneficiaries "greater opportunity and flexibility to utilize these planning sessions at the most appropriate time for patients and their families," according to a fact sheet about the proposed rule.
It's an important first step to better care, Phillip Rodgers, M.D., of the American Academy of Palliative and Hospice Medicine, told FiercePracticeManagement in an exclusive interview. Research proves end-of-life discussions improve quality of care and life for seniors, he said, adding that the move is a "win-win-win" that is "widely supported by the majority of physicians, patient organizations and payers in the U.S."
While some have fretted about end-of-life counseling--the controversial so-called "death panels" mandated by the Affordable Care Act--Rodgers said the new rule proposal makes his group hopeful such worries "have been put to rest."
Echoing this sentiment, the American Medical Association said in a statement that "this issue has been mischaracterized in the past and it is time to facilitate patient choices about advance care planning decisions."
As for the Physician Quality Reporting System (PQRS), CMS wants to "add measures where gaps exist, as well as to eliminate measures that are topped out, duplicative or are being replaced with a more robust measure."
Physicians in the past have been frustrated with the system in part due to internally contradictory program instructions and explanations from CMS.
If physicians or group practices do not satisfactorily submit data on PQRS measures, they could face a 2 percent Medicare payment penalty in 2018.
"CMS is building on the important work of Congress to shift the Medicare program toward a system that rewards physicians for providing high quality care," Andy Slavitt, a CMS administrator, said in a statement.
CMS also proposed changes to its Medicare Shared Savings Program (MSSP) and to its Physician Compare website. For MSSP, CMS wants to offer flexibility for accountable care organization participants to alter quality measures, and it seeks to clarify how PQRS requirements interact with ACO quality measures, among other modifications.
For Physician Compare, CMS wants to add various reporting measures to the consumer-targeted website, including noting when a physician or practice was eligible but chose not to report quality measures to CMS.
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