Reimbursement for Advance Care Planning: Why Should Intensivists Care?

Randy Curtis writes about “Reimbursement for Advance Care Planning:  Why Should Intensivists Care?” in the current issue of the American Journal of Respiratory and Critical Care Medicine (184 (2011): 387–400). 

“There are few professional groups that stand to lose more business by the systematic implementation of advance care planning than critical care clinicians.  Therefore, you would think this provision would be opposed by the four largest critical care societies: the American Association of Critical Care Nurses, American College of Chest Physicians, American Thoracic Society, and Society of Critical Care Medicine.  So why do these professional societies, representing more than 100,000 critical care clinicians through a collaborative known as the Critical Care Societies Collaborative, strongly support this Medicare regulation [providing reimbursement to physicians for optional annual advance care planning]?”

Curtis responds:  “Because advance care planning—when done early and effectively—increases patient autonomy, improves quality of life for patients and their families, and reduces the suffering that we observe frequently in ICUs.”  In addition to Medicare reimbursement, Curtis offers several other steps we must take “to ensure that our healthcare system truly supports patients and their families.”