Advanced care planning conversations dropped from wellness exam

One of the more controversial components of the health care reform law has been the inclusion of advanced care planning as part of a Medicare annual checkup or wellness visit. The specter of "death panels" initially resulted in the elimination of the payment for physicians to talk with patients about advanced care planning, but the payment reappeared in a Medicare regulation that described the items covered in an annual or wellness visit.

The decision to once again drop compensation for advanced care planning conversations came just one week before a Republican-led effort in the House of Representatives to repeal President Obama's health care overhaul.

"We are surprised that the administration has decided to reverse the decision to include voluntary advance care planning consultations as part of a Medicare beneficiary's annual wellness exam," says J. Donald Schumacher, president and chief executive officer of the National Hospice and Palliative Care Organization. "Frankly, we are somewhat disappointed that the regulatory guideline making this part of the annual Medicare exam and compensating the physician for taking time to talk about personal preferences has become such a political issue." Schumacher points out that the advanced care planning consultation is to educate patients about decisions they might need to make in the future and supporting their choices.