Bioethics for Breakfast: Is it just the money? Reimbursement for Advance Care Planning

Rose Seavolt, BSN, RN, CCP, presented at the Bioethics for Breakfast event on October 8th, offering insight perspective on the topic, “Is it just the money? Reimbursement for Advance Care Planning.”

In 1991 Congress passed the Patient Self Determination Act as a way of encouraging individuals to do advance care planning for future situations in which they, as patients, were incapable of making health care decisions for themselves. The law required hospitals and other health care facilities to inquire whether patients already had such directives, or would like the opportunity to complete such a directive. But no one would be paid to spend time with a patient to help them formulate more thoughtful directives. In 2009 the Obama Administration proposed paying physicians to provide this service as part of the health reform effort, but inflammatory “death panel” rhetoric resulted in that proposal’s quick demise. The innuendo was that physicians would counsel patients to accept an earlier death in order to save money for their hospital or health care system.

The Centers for Medicare and Medicaid Services (CMS) is again proposing to pay physicians and other health care providers to offer this service. In this Bioethics for Breakfast session we considered a more thoughtful assessment of this proposed legislation, both from a policy perspective and from the perspectives of patients, families, and health care professionals charged with carrying out this responsibility.

Rose Seavolt, BSN, RN, CCP
Rose Seavolt is an Advance Care Planning Coordinator and Next Steps Organizational Faculty for Spectrum Health System, Grand Rapids, MI, and certified in the Respecting Choices® model of advance care planning as a facilitator in all three steps and an instructor in First and Last Steps. Rose has clinical and leadership experience with individuals across the lifespan from neonates to geriatrics and various levels of engagement within healthcare systems. Rose has been instrumental in the development and introduction of each of the steps of advance care planning within Spectrum Health and the greater Grand Rapids area.

About Bioethics for Breakfast:
In 2010, Hall, Render, Killian, Heath & Lyman invited the Center for Ethics to partner on a bioethics seminar series. The Center for Ethics and Hall Render invite guests from the health professions, religious and community organizations, political circles, and the academy to engage in lively discussions of topics spanning the worlds of bioethics, health law, business, and policy. For each event, the Center selects from a wide range of controversial issues and provides two presenters either from our own faculty or invited guests, who offer distinctive, and sometimes clashing, perspectives. Those brief presentations are followed by a moderated open discussion.