Quality Measurements, Payment, and the Law: Disincentives to Physician-Patient Discussions of End-of-Life Care

“Quality Measurements, Payment, and the Law: Disincentives to Physician-Patient Discussions of End-of-Life Care” is the title of a new article by Missouri health lawyer Harvey M. Tettlebaum in the Journal of Health & Life Sciences Law.  Here is the abstract:

With passage of the Affordable Care Act, the government is playing a dramatically increasing role in not only payment for healthcare but also the standards by which care is delivered. Therefore, it is important that the disincentives to patient discussions of end-of-life care in the laws and regulations, and the mechanisms used to enforce both, be well understood to avoid in the future what has occurred in the past.

Here is the table of contents:

• Introduction                            
• Shortcomings of the Patient Self-Determination Act
• Impediments to End-of-Life Discussions
• The culture of life and death           
• Physicians                              
• Payment structures and systems          
• Hospice audits and enforcement          
• Other regulatory standards and administrative enforcement
• Emergency Medical Treatment and Active Labor Act
• Need for Culture Change                 
• The Patient Protection and Affordable Care Act
• Conclusion