The Blog to Transform Advanced Care

Advancing Care through Innovation, Observation and Collaboration.

Advance care planning (ACP) is more important now than ever as we face the uncertainties of the COVID-19 pandemic and C-TAC is pleased that these important services can now be delivered through audio-only telehealth technology. This change, outlined in the second round of blanket waivers released by the Centers for Medicare & Medicaid Services (CMS) on April 30, is a key policy priority for C-TAC and we welcome this effort to expand access to ACP services.

C-TAC recommended allowing audio-only ACP conversations to be billable by Medicare in our April 22 letter to leadership at CMS and the U.S. Department of Health and Human Services (HHS). Many individuals faced with serious illness in this crisis are older and/or come from low-income communities and do not have access to technologies that would allow for both audio and visual capabilities, such as smartphones, that the previous telehealth flexibilities required. Allowing ACP conversations to be conducted through audio-only means addresses a major equity issue and promotes equal access to this important process.

We were gratified to learn that CMS implemented this recommendation and put ACP services within reach for communities across the country who might not otherwise have access to advance care planning.

“We welcome this decisive action by CMS to expand access to advance care planning as we face the unprecedented challenges of the COVID-19 pandemic,” said C-TAC Executive Director Jon Broyles. “Allowing for audio-only advance care planning will enable more of our members and partners to lead these important conversations with those in their care at a time when they are needed most.”

This development has also been praised by those who share C-TAC’s dedication to palliative care and advance care planning:

“We’d been hearing from so many programs that the urgent need for palliative care services – particularly to hold conversations with family members not able to visit the hospital – simply precluded the ability to set up both audio and video prior to the outreach. The ability to bill for advance care planning as audio-only is a big win, reflecting the reality of palliative care during the COVID crisis,” said CAPC Vice President of Payment and Policy Allison Silvers.

“While COVID-19 has created urgency around having conversations to understand a person’s goals of care, there have also been logistical challenges for consumers and clinicians working to create or update them,” said Sandra Severson, Vice President of Care Improvement at the Arizona Hospital and Healthcare Association. “The Coalition to Transform Serious Illness Care in Arizona supports the use of audio only technology for advance care planning as it reduces overwhelming barriers and promotes patient centered care.”

We are glad to see that recommendations submitted by C-TAC are aligning with actions taken by CMS to support those with serious illness and their families during this difficult time. We will continue to work closely with our partners and champions in the Administration and Congress as they craft new policies  in response to the COVID-19 pandemic to ensure that those solutions provide support for the serious illness population. More work in particular is needed to address remaining barriers to high-quality advance care planning, including removing cost-sharing associated with these services, expanding the kinds of providers who are eligible to be reimbursed for leading these conversations, and ensuring that a person’s advance care plan travels with them and is honored across state lines.

Advance care planning will also be a central topic of discussion during our National Policy Forum, taking place from 1 – 4 PM ET on Wednesday, June 24. Join us for this free, virtual event as leaders and innovators in our field share in-depth analysis and updates on the ways in which the COVID-19 pandemic has re-shaped the policy landscape for serious illness care. To learn more and register today, please click here.

For more information about C-TAC’s legislative and regulatory efforts, please contact Policy & Advocacy Manager Davis Baird at DBaird@theCTAC.org.

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