Excellus BCBS endorses new IOM report on end-of-life care
ROCHESTER, NY (09/17/2014)(readMedia)-- Excellus BlueCross BlueShield endorses a new report issued Sept. 17, 2014, by the Institute of Medicine on ways to improve care for individuals at the end of their life.
In fact, Excellus BCBS and community groups throughout upstate New York already have implemented many of the changes cited in the report, Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life.
In the report, the Institute of Medicine's Committee on Approaching Death – Addressing Key End-of-Life Issues recommended:
- All insurers should cover comprehensive care for individuals with advanced serious illness who are near the end of life;
- Quality standards should be developed for clinician-patient communication and advance care planning;
- Appropriate provider training, certification and licensure should be developed to strengthen palliative care knowledge and skills of all clinicians;
- All insurers should integrate the financing of medical and social services to support quality care consistent with patients' values and preferences; and
- Fact-based public education that encourages advance care planning and shared, informed medical decision-making
The full report can be found at http://www.iom.edu/Activities/Aging/TransformingEndOfLife/2014-SEP-17.aspx
Since the last IOM Report on end of life care in 1998, Excellus BCBS has been a leader in improving the quality of care for patients at the end of life. For example, Excellus BCBS already reimburses trained and qualified doctors for having end-of-life talks with their patients. Such efforts were recently featured in an editorial and front page article in the New York Times.
Spearheading the advance care planning efforts at Excellus BCBS is Patricia Bomba, M.D., of Pittsford, vice president and medical director, geriatrics. Bomba served on the Institute of Medicine committee of national experts that wrote the recommendations.
"The IOM report highlights Excellus BCBS's work since 2001 in several areas, including physician reimbursement, advance care planning education and Medical Orders for Life-Sustaining Treatment," Bomba said. "In spite of all the work we have done, there's more work to do to meet patients' end-of-life care needs and ensure that patients' values and preferences are honored. Excellus BCBS remains committed to be a leader in transforming end-of-life care by implementing the IOM recommendations with our health system partners."
Bomba is a nationally recognized end-of-life expert who designs and oversees community projects in New York. She has trained thousands of health care providers in palliative care skills, including advance care planning and MOLST. She also provides fact-based public education programs that encourage everyone age 18 and older to have a family discussion, complete a health care proxy and use MOLST when appropriate.
Bomba has organized advance care planning training for hundreds of health care providers in New York state, including 150 providers who are scheduled to undergo MOLST and eMOLST training on Sept. 24 in Utica, which will qualify physicians, NPs and PAs for improved reimbursement.
"As a result of our work, New York is ahead of the curve. We have innovative tools and resources, like eMOLST," Bomba said." We now need to implement them with our health system partners, and ensure sustainability of their use."
For more information on advance care planning, go to CompassionAndSupport.org.
The Institute of Medicine is an independent, nonprofit organization that works outside of government to provide unbiased and authoritative advice to decision-makers and the public.
What are advance directives and MOLST?
- MOLST: A Medical Order for Life Sustaining Treatment is a legal document that physically travels with the patient throughout all levels of care, or the eMOLST form that's kept in the patient's electronic medical records. Seriously ill or frail patients who are likely to die within a year can use MOLST to specify the level of health care they want and don't want.
- Health Care Proxy: Designates an "agent" to make health care decisions on your behalf only if you are unable to make decisions yourself.
- Living Will: Permits you to state your wishes ahead of time in case you develop a terminal, irreversible condition that prevents you from making and communicating your wishes. It's not a legal New York state form, but does provide "clear and convincing evidence" needed to have your wishes carried out.
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Excellus BlueCross BlueShield, a nonprofit independent licensee of the BlueCross BlueShield Association, is part of a family of companies that finances and delivers vital health care services to about 1.6 million people across upstate New York. Excellus BlueCross BlueShield provides access to high-quality, affordable health coverage, including valuable health-related resources that our members use every day, such as cost-saving prescription drug discounts and wellness tracking tools. To learn more, visit http://www.excellusbcbs.com.