The Greatest Gift

With the holidays just around the corner, we look forward to spending time with our families.  Children returning home from college or parents visiting from out of town make this time even more precious than ever.  The season is a time to be together, catch up with friends and other family, and to give thanks. 

Being together with family and loved ones also provides an opportunity to talk about what we want if we are ever unable to make decisions about our medical care.  Advance care planning allows us to be in control of our care, and reflects what we want in anticipation of difficult times. Doing this planning is easier when life is going well than in an unexpected situations.  Advance care planning is a gift to our decision makers, since it enables them to know and follow our wishes if the situation arises.

Advance care planning is a process you can engage in with your patients to anticipate your needs and to document it, Partnership HealthPlan strongly encourages our staff, providers and members to complete an advance directive.  One of the simplest and clearest advance directive forms was developed by the Institute for Healthcare Advancement and is available here, including translations into multiple languages.

Encouragingly, the Center for Medicare and Medicaid Services (CMS) recently announced that it would begin to reimburse providers for advance care planning discussions.  The two new advance care planning codes are:

  • 99497 (for an initial 30 minute voluntary advance care planning consultation
  • 99498 (the add-on code for additional 30 minute time blocks)

CMS will begin reimbursing for these consultations starting January 1, 2016.  See these posts by the California Coalition for Compassionate Care here and Kaiser Family Foundation here for more information about this ruling and other FAQs related to end of life care.

For individuals who are seriously ill or with chronic, progressive illness, Partnership HealthPlan also encourages completing a Physician Orders for Life-Sustaining Treatment (POLST) form.  The POLST is a tool that encourages discussion between patients and providers about end-of-life treatment options and preferences.  The key difference between the POLST and an advance directive is that the latter is the legal means to appointing a health care decision maker.  The POLST is principally used in emergent situations and complements an advance directive.

Starting January 1, 2016, nurse practitioners and physician assistants, under the direction of a physician and within their scope of practice, will be able to sign the POLST and make the form actionable.  The POLST form is available in multiple languages at the California POLST web site.

Give yourself and encourage your family and patients to give the gift of advance care planning.  The ability to know and follow a loved one’s wishes is priceless.

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