Changes to Medicare in 2016: advance care planning & more

February 18, 2016

by Kim Magness, Billing Administrator

Every year the Medicare program evolves and the subsequent changes affect millions of Medicare beneficiaries. This year, Medicare has adjusted its benefits to cover advance care planning for patients that want to discuss end-of-life care options with their providers. Beneficiaries have also seen increases in their monthly premiums and deductibles associated with Medicare Part B.

Medicare

Advance care planning helps patients identify their care wishes

Research has found that most adults (90 percent) say they would prefer to receive in home care at the end of life if they were terminally ill, yet data show that only about one-third of Medicare beneficiaries (age 65 and older) died at home.1 

Advance care planning is a process that helps empower patients and their families to determine what types of care best align with their personal wishes and to share those wishes with their healthcare providers. This not only benefits patients and their families, by avoiding unwanted and invasive care at the end of life but will save Medicare the millions of dollars it costs to deliver this care.

Medicare recognizes the importance of assuring that its beneficiaries have an opportunity to consider and discuss end-of-life care preferences with their healthcare professionals. End-of-life care includes all health care provided to someone in the days, months or years before their death, whether death is a result of a sudden incident or a long-term illness.

Advanced care planning is covered by Medicare

Beginning January 1, 2016, Medicare started to cover advance care planning conversations as a separate benefit available under the traditional fee-for-service cost sharing plan. If beneficiaries wish to obtain this service from their primary care providers (physicians, nurse practitioners or physician assistants) in conjunction with their Annual Wellness Visit, practitioners will bill for this service separately, however, the patient will incur no cost (copay) for this service. 

Increases to Medicare Part B

For some beneficiaries, Medicare Part B monthly premiums have increased this year in order to offset the cost of the Medicare program and the 11,000 people a day who are enrolling in the program. While it’s not unusual for most Medicare participants to see a small premium rise annually, this year about 30% of utilizers experienced a premium increase of approximately 16%. The Medicare deductible also rose by $19 to $166 for Part B services, along with costs associated with skilled nursing and inpatient stays.

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1   Approaching Death: Improving Care at the End of Life, Institute of Medicine, 1997; Joan M. Teno et al., “Change in End-of-Life Care for Medicare Beneficiaries,” JAMA 2013;309(5):470-77.

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