Primary Care Practitioners End of Life Care Program Personcentered care honoring individual preferences Sarah Lawrence established End of Life Care Program on personcentered foundation Dignity in health care at all ages stages of life ID: 1032743
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1. Advance Care Planning: Learning Opportunities for Primary Care Practitioners
2. End of Life Care ProgramPerson-centered care honoring individual preferences Sarah Lawrence established End of Life Care Program on person-centered foundationDignity in health care at all ages, stages of lifeIncrease knowledge of, advocacy for, and access to comprehensive care Provide in-depth training in advance care planning
3. Advance Care Planning
4. Advance Care Planning Purpose of the presentationNew CPT Codes 99497 and 99498Opportunity 1: One-hour webinar with Patricia Bomba, MD, FACP – advance care planning in your practice; March 22Opportunity 2: Advance Care Planning for Primary Care Practitioners – a four-course certificate
5. Medicare Part B ACP Reimbursement—Jan 1, 2016The News Advance care planning for patientsMedicare reimbursements for eligible practitionersWhat does that mean?Codes 99497 and 99498 are now ACTIVE on the 2016 fee scheduleEligible practitioners are physicians, physician’s assistants, nurse practitioners, licensed clinical social workers
6. Advance Care Planning CodesWhat do practitioners talk about?Quality of life expectations through transitions in healthPatient’s preferences for treatment and options for achieving goalsAdvance care planning tools – e.g., living wills, health care proxies, and moreAdvance care planning forms
7. Other ACP CharacteristicsWho starts the conversation?Patient can initiate conversationPhysician can initiate when there has been a change in status or a transition in careAdvance care planning is voluntary, patient’s discretionFace-to-face only; no telemedicinePatient must be present unless he or she lacks capacity
8. Incorporating ACP into the Practice
9. Medicare Support for ACPWhy are there two codes?99497 applies to the first 30 minutes of an advance care planning discussion99498 applies to each additional 30 minutes (in conjunction with 99497)Codes do not exclude other members of a practice from taking part, butBilling practitioner must “manage, participate and meaningfully contribute to the provision of these services”
10. Medicare Support for ACPWhen can the codes be used?Same day as other evaluation/management (E/M) visits, transitional care management (TCM), or chronic care management (CCM) visitAnnual Wellness Visit (AWV) – no cost sharing No active clinical management takes placeNo limit on number of times matter is discussedCodes cannot be used in certain critical care and intensive care situations
11. Advance Care Planning ConversationsWhat if I can’t answer all my patient’s questions?CMS.govNational Hospice and Palliative Care OrganizationAmerican Academy of Hospice and Palliative MedicineEnd of Life Care ProgramCompassion and Support at the End of Life
12. CPT Codes for ACP and POLSTLive Webinar with Patricia A. Bomba, MD, FACPMarch 22, 201611:00AM-12:00PM Eastern TimeRegistration at End of Life Care Program
13. CPT Codes for ACP and POLSTPatricia A. Bomba, MD, FACPExpert in palliative and end of life careMember, National POLST Paradigm Task ForceWhat will be coveredAdvance care planning spectrumHow and when to use Codes 99497 and 99498Advance directives (general principles and legal forms)Overview: National POLST protocols
14. Certificate: Advance Care Planning for Primary Care Practitioners
15. Certificate: Advance Care Planning for Primary Care PractitionersContribute to comprehensive care culture through educationEncourage expression of patient wishes throughout care journeyFocus on key skills for practitionersAid in delivery of service consistent with Medicare Part B
16. ACP for PCPs: The CoursesFour one-hour online courses emphasizing advance care planning in the office settingWhy Advance Care Planning and Skills for Performing ItThe Patient and Legal Aspects of ACPFrom Quality of Life Conversation to Completing ACP FormsPutting ACP Into Practice – A Live, Remote SimulationAll four courses comprise the certificate
17. ACP for PCPs: The TeachersSeasoned faculty with broad experienceHealth lawPatient representation, advocacyMedical family practiceMedical practice education
18. More about the CertificateWhen is the certificate program available?Courses available online beginning in April 2016 SLC sponsoring CME, Nurse CE and MSWCE units through joint providership with National Hospice and Palliative Care Organization (NHPCO)Descriptions, fees, and registration information atEnd of Life Care Program(https://www.sarahlawrence.edu/ce/eol.html)
19. Contact:Rebecca O. JohnsonAssociate Program DirectorGraduate and Professional Studiesrjohnson@sarahlawrence.edu (914) 395-2316End of Life Care ProgramSarah Lawrence College
20. “…a person-centered, family-oriented approach that honors individual preferences and promotes quality of life through the end of life should be a national priority.”Dying in America: Improving Quality and Honoring Individual Preferences Near the End of LifeInstitute of Medicine, 2014