Why pay for end-of-life conversations?

A story by Pam Belluck in the New York Times left me with mixed feelings.  Here's an excerpt:Five years after it exploded into a political conflagration over “death panels,” the issue of paying doctors to talk to patients about end-of-life care is making a comeback, and such sessions may be covered for the 50 million Americans on Medicare as early as next year.Bypassing the political process, private insurers have begun reimbursing doctors for these “advance care planning” conversations as interest in them rises along with the number of aging Americans. Some states, including Colorado and Oregon, recently began covering the sessions for Medicaid patients.Who can doubt that such conversations are useful, helpful, humane, and more? But do we really need to pay doctors for them? And if so, how should such payments be structured?  The story goes on:But the impact would depend on how much doctors were paid, the allowed frequency of conversations, whether psychologists or other nonphysicians could conduct them, and whether the conversations must be in person or could include phone calls with long-distance family members. Paying for only one session and completion of advance directives would have limited value, experts said.“This notion that somehow a single conversation and the completion of a document is really an important intervention to the outcome of care is, I think, a legal illusion,” said Dr. Diane E. Meier, director of the Center to A...
Source: Running a hospital - Category: Health Managers Source Type: blogs