Center for Medicare/Medicaid Services releases "Final Rule" on Death Conversations

A friend forwarded this email from CAPC, the Center to Advance Palliative Care: CMS Final Rule Highlights Importance of the Patient-Clinician Relationship Late last week, the Center for Medicare and Medicaid Services (CMS) released a Final Rule under which it will reimburse clinicians who conduct advance care planning (ACP) conversations with their patients who are seriously ill. This change, effective January 1, 2016, is yet another indicator of payers not only appreciating the importance of establishing a trusting relationship between patients and their clinicians, but recognizing that developing these relationships take time - time that must be paid for.  "The purpose of the ACP code is to ensure that clinicians truly understand what is most important to patients and their families so that, as the future unfolds, the care we provide supports their highest priorities," says CAPC Director, Diane E. Meier, MD. "As America's largest payer, CMS is sending a strong signal to the health care system at large that it recognizes and rewards the irreducible value of the clinician-patient relationship." CAPC applauds this change and looks forward to working closely with CMS and other stakeholders to ensure that patients will receive care that effectively manages their symptoms and improves their overall quality of life. For more information on how this policy change will improve the lives of patients with serious illness, view the CMS Fact Sheet as well as recent coverage from CBS Evening News. _________________________________________  As I read the email, I couldn't help but think how appropriate the name "final solution rule" is. On the CAPC website you find many articles lamenting the cost of caring for patients with dementia. Reading between the lines, one can guess where this is leading -- wiping the slate clean by wiping out the patients.  A recent study showed one in three doctors in Holland would provide the lethal drugs to dementia patients. How many patients are already being killed involuntarily by dehydration, starvation, terminal sedation, and use of strong anti-psychotic drugs?  Quality of life is the watchword. If anybody uses that term, head for the hills with your loved ones. No one is guaranteed a particular quality of life. What we are guaranteed is the love of Our Father in heaven who sees the weak and the vulnerable as "little ones" who deserve special care. But we live in a post-Christian Darwinian world where "survival of the fittest" is often the measure of how one is treated. And organizations like CAPC are the overseers of this brave new world. May God help us and our vulnerable loved ones.