The Pew Charitable Trusts supports bipartisan legislation introduced today in the U.S. Senate that would improve care for people who are near the end of their lives. The Care Planning Act, authored by Senators Johnny Isakson (R-GA) and Mark Warner (D-VA), would establish Medicare coverage for advance care planning, thereby increasing access to this important service that supports patients and families in discussing and documenting care preferences. The bill would also give priority to, and fund, the development of quality measures that would encourage health systems and insurers to improve the care they provide and test new models to deliver health care services to those with advanced illnesses, among other provisions.
The care that Americans receive near the end of life does not often reflect their values, goals, and preferences. Research has shown that seriously ill patients derive significant benefits from advance care planning. Patients who participate in these conversations with their health care providers are more likely to have their end-of-life wishes known and respected, more likely to be satisfied with their care, less likely to receive unwanted medical interventions in the last weeks of life, less likely to die in the hospital or intensive care unit, and more likely to receive hospice care.
Unfortunately, numerous studies have demonstrated that even the sickest patients often do not take advantage of advance care planning. Establishing Medicare reimbursement for voluntary discussions among health care professionals, patients, and their families will help ensure that patient wishes are honored.
Pew commends Sens. Isakson and Warner and all co-sponsors of this bipartisan legislation for their efforts to improve end-of-life care. Similar legislation is expected to be introduced in the House.
The Pew Charitable Trusts’ improving end-of-life care project seeks to expand access to advance care planning, develop tools to measure the quality of care, highlight innovative ways of providing care to seriously ill people and their families, and improve the documentation of patients’ wishes for their care near the end of life.