By W. Stephen Love, President/CEO, DFW Hospital Council

On Wednesday, the Centers for Medicare and Medicaid Services (CMS) proposed changes to the 2016 Medicare Physician Fee Schedule, including paying for the controversial end-of-life counseling.

Six years ago, a proposal for Medicare to cover end-of-life counseling touched off a political storm leading to discussions of “death panels.” Yesterday, when Medicare finally announced it would make the change, reaction was mainly one of U.S. acceptance.

Discussions related to death are always difficult. Many patients and their families are ill-equipped to have candid dialogue about end-of-life planning. We need compassionate and constructive discussions about advance directives, palliative care and hospice treatment. Physicians are an integral participant in these discussions with scientifically-based knowledge regarding serious medical conditions. Today, many physicians and hospitals are including palliative and hospice initiatives in chronic care. With managed care plans in Medicare and Medicaid focusing on value outcomes for patients, they too will engage with hospice and palliative care partners.

The Centers for Disease Control and Prevention said U.S. life expectancy in 2012 was an average age of 78.8 – a record high. Female expectancy was 81.2 years and males were 76.4 years. The life expectancy of people aged 65 was 19.3 years on average. As these revealing numbers show, we are living longer and as we age, we tend to require more medical treatment for chronic illnesses. End-of-life discussions are becoming more important than ever before.



We all support the “Triple Aim” of better health, better care and better value. End-of-life planning with religious, medical and family participants is a crucial component in better care for the patient. Let’s not divert legitimate focus on patient dignity with crude rhetoric about death panels.

The CMS end-of-life physician payment for counseling is a proposal, with interested parties having 60 days to comment before it is finalized, but it is clearly a step in the right direction.