Wednesday, December 24, 2014

Last minute gift idea

by Holly Yang, MD

Dear HPM colleagues,

For those of you who celebrate Christmas (and for those of you who are waiting patiently for the after Christmas sales), you'll be happy to know that there is still a chance to ask your friends and relatives for a gift, one they can get online without going to that crazy mall or fighting through traffic. Heck, give the present to yourself!

Ask CMS to pay providers for having advance care planning conversations. There are codes now (yay!), just no reimbursement (insert frowny emoji here).  BUT... the comment period to CMS is open until Dec. 30th, so if you are a procrastinator, not to worry. You still have time!

Ask your non-HPM friends to do it. It matters to them too! Do you think a primary care doc can fit in an ACP conversation into a 10-15 min. visit for their patient scheduled for another problem? Or an annual exam where they are supposed to do a full H and P, counsel against smoking, promote healthy eating, exercise, ask about gun safety, screen for domestic violence, and catch up with major events in a patient's life? What about the specialist who also has to fit it into a busy clinic day packed to the brim with scheduled and urgent, unscheduled visits? We love our patients. It's just that often it doesn't come to the forefront of conversation until it becomes an urgent issue or a true crisis. We need to have these conversations valued as "separately and identifiably" necessary part of providing high-quality, patient-centered care.

Besides, commenting isn't just good for our patients... all the cool kids are doing it. AAHPM, CAPC and AGS submitted. Paul Tatum, Kyle Edmonds, Laura Petrillo, and Alex Smith did too. Lots of people did. Patients, doctors, lawyers, academies, associations... you can too!

For those who like info short and sweet, I've already annoyed you. Quit reading and go here.
Push Ctrl-F on a PC (Command-F on a Mac) and search "99497" or "99498" to read what CMS is currently planning to do.

At the very top of the webpage click the "Submit a Formal Comment" button.

For the detail people, please see the HPM blog trifecta on the subject by my esteemed colleagues Gregg VandeKieft, Paul Tatum, and Phil Rodgers, which are very rich resources:

For those who are more politically motivated or feeling a bit cranky from all the relatives in your house and need a way to vent, read Laura's Geripal post here.

Your opinion matters. It really, really does. CMS is listening (until Dec. 30th, that is...) No complaining that you don't get reimbursed for having advance care planning conversations if you don't avail yourself of this opportunity. Just think... wouldn't it be awesome to have one less barrier to patient-centered care?

It's Christmas Eve! The Elf on the Shelf is watching you to see if you are naughty or nice...

Photo credit: Alan Dow (used with permission)

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