What was the top medical news story in 2015? In November, Medscape (a medical website from WebMD) asked just that of its readers — primary care physicians, specialists and other health professionals – and more than 400 replied. Number one was: a major change in diagnostic codes, known as ICD-10. Not surprising, perhaps, as there are many more new codes for physicians to ponder, and probably much more administrative time required, as a result, to the chagrin of small practice owners. (http://www.medscape.com/viewarticle/855309)
If we’re talking about developments that have the potential to make a big difference for patients in the coming years, though, I’d like to suggest at least two that ought to top the list.
My first “top news” story affects advance care planning. At long last, as of January 2016, you and your doctor will be able to discuss your goals, beliefs, values and fears should you become seriously ill – and Medicare will actually reimburse him or her for doing it. Granted, the reimbursement isn’t huge — $86 for a mere 30-minute discussion and $75 for a follow-up – but maybe it will be enough of an incentive to encourage more physicians to engage in these critical conversations.
These are difficult discussions to engage in, whether you’re talking with family and friends or your physicians. And too many physicians’ communication skills leave something to be desired. But the goal is to make sure that if you become very ill – particularly if you are not able to speak for yourself – your care will reflect your wishes and values.
My second “top news” story was the selection of hospices that will participate in the Medicare Care Choices pilot project, with implementation beginning in January 2016.
The Care Choices pilot will allow certain hospice patients with advanced cancers, chronic obstructive pulmonary disease (COPD), congestive heart failure, or HIV/AIDS to elect hospice care without having to give up curative treatments.
Originally, the Centers for Medicare and Medicaid Services (CMS) was going to pick at least 30 rural and urban Medicare-certified and enrolled hospices to participate. It expected to enroll 30,000 beneficiaries over a three-year period. But because there was so much interest in the pilot, CMS expanded it to more than 140 Medicare-certified hospices and extended the duration of the project from three to five years. It expects to enroll as many as 150,000 eligible Medicare beneficiaries.
Why is this important? Because the idea of forgoing treatment aimed at cure – currently a requirement to enter into hospice care – has discouraged too many patients and their physicians from considering comfort care solely. Ideally, when the pilot is done, there will be useful evidence about whether concurrent care (curative and comfort) improves quality of life and results in fewer hospital readmissions and, possibly, lower Medicare costs.
In my “wishful thinking” category: Maybe in 2016 CMS will announce it is eliminating the six-month prognosis requirement for patients to enroll in hospice care. That would certainly get my vote for top medical news story next year!