A recent story in the USA Today reports the federal government may finally reimburse doctors for talking to Medicare patients about their End-of-Life options. The recommendation by The American Medical Association’s Relative Value Scale Update Committee (RUC) will go to the federal agency that administers the Medicare program, which is the country’s largest health insurer. “This is supported by 90 percent of the public,” said U.S. Rep. Earl Blumenauer of Oregon. But until now, “the federal government has placed no value on this conversation.” The current effort began last year when the Illinois State Medical Society recommended the AMA adopt specific medical codes for the reimbursement of doctors who use office time to discuss a patient’s End-of-Life preferences. Medical codes describe medical procedures and are used by medical providers, hospitals and insurers across the country. In response to the Illinois request, the AMA has recommended a new code specifically for advance planning. Currently, healthcare providers who have End-of-Life conversations with their patients must fit them into appointments held for other purposes. “You essentially have to be deceitful to get paid to do advance care planning,” said Christopher A. Jones, an assistant professor of palliative care at Duke University. A vast majority of healthcare providers believe End-of-Life discussions shouldn’t be squeezed in among other medical exams and procedures. Doctors who treat terminal patients also believe if Medicare reimburses them for having End-of-Life discussions (like it does for examining patients and performing procedures) they will be more likely to happen. When given a choice, numerous studies show patients will often forgo aggressive treatments because the procedures are extremely costly and rarely extend a patient’s life. The lack of compensation for End-of-Life discussions is part of a broader pattern in the healthcare industry. Studies show compensation for doctors who perform procedures is much higher than primary care doctors whose practices involve diagnosis and noninvasive treatment. “This is a difficult conversation for both doctors and families that takes time and focused attention,” Blumenauer said. Presently, “if reimbursement occurs at all, it’s incidental to the primary treatment or somebody miscodes, and that’s not the way it should be.” Read the story here.