Warner, Isakson, Blumenauer & Roe Introduce Bipartisan Legislation to Enhance Planning Options for Patients with Advanced Illnesses
Legislation would provide new ways to test, measure, and improve options for patients seeking advance care planning
Jun 12 2017
WASHINGTON – Today, U.S. Sens. Mark R. Warner (D-VA) and Johnny Isakson (R-GA), both members of the Senate Finance Committee, and Reps. Earl Blumenauer (D-OR), a member of the House Ways and Means Committee, and Phil Roe (R-TN), a member of the House Education and Workforce Committee, introduced bipartisan legislation designed to give people with serious illness new tools to plan for their care, and empower them to have those choices honored.
The Patient Choice and Quality Care Act of 2017 offers a person-centered approach to planning for care and treatment of patients with advanced illness by testing and evaluating new models for the delivery of care to patients with serious illnesses, and enhancing existing Medicare coverage for end-of-life services to help ensure that the care a patient receives is in line with their values and choices. The bill also provides $50 million in grants to promote public and provider education about advance care planning and care.
“When faced with a serious illness, we must empower individuals to have the freedom to control how they will live and be taken care of for the rest of their lives. Having early conversations on this very difficult topic can help families and patients have their wishes known and their voices heard,” said Sen. Warner, whose mother, Marjorie, passed away from Alzheimer’s disease in 2010 at the age of 81.“One of my biggest regrets is not having these discussions with my own mother, who suffered for 11 years with Alzheimer’s. Nine of those years, she couldn’t speak. Our bill will help patients get the care that they want, and allows their doctor and providers to better understand the choices they and their loved ones have made for their future.”
“I strongly believe that, when a person is faced with life-threatening illness, having a face-to-face conversation with their doctors, caregivers and religious advisors is crucial to wise decision-making,” said Sen. Isakson. “The Patient Choice and Quality Care Act of 2017 empowers patients to take charge of their own health care by providing them with the opportunity to make more informed choices and the power to have those choices honored. From my own experience with my parents, I understand how difficult these decisions can be, and having a plan helps offer a higher quality of life during a loved one’s last days.”
“Our healthcare system fails to support families confronting serious medical decisions. I’ve worked for a decade to make sure patients and their loved ones can work with their doctor to navigate the health care process at the end of life,” said Rep. Blumenauer. “This bipartisan, bicameral legislation builds on the progress we’ve made to deliver patient-centered care, and it gives providers, families, and caregivers the tools they need to face these challenging issues.”
“As a physician, some of the hardest discussions I’ve ever had were about a patient’s end-of-life wishes. Whether it was with a patient of mine, or someone in my own family, these conversations – while difficult – are so critically important in providing certainty and comfort when caring for a loved one with a serious illness, which is why I’m proud to partner with Rep. Blumenauer to introduce the Patient Choice and Quality Care Act,” said Rep. Roe. “Encouraging patients and their families to have these conversations with their physician helps provide peace of mind and undoubtedly increases the likelihood a patient’s care will be consistent with their wishes.”
The Senate version of this bill is cosponsored by Sens. Tammy Baldwin (D-WI), Susan Collins (R-ME), Amy Klobuchar (D-MN), and Shelley Moore Capito (R-WV).
This legislation has the support of both national and local health care and elder advocacy organizations including: Alzheimer’s Association, American Association of Retired Persons (AARP) American Bar Association, American Geriatrics Society, American Heart Association, American Osteopathic Association (AOA), American Society of Aging, Blue Cross Blue Shield of California, Blue Cross Blue Shield of Massachusetts, Cambia Health Solutions, Capital Caring Hospice, Catholic Health Association, Coalition to Transform Advanced Care (C-TAC), Commonwealth Care Alliance, Compassus, LeadingAge, National Association for Home Care & Hospice, National Coalition on Healthcare, National Hospice and Palliative Care Organization (NHPCO), National Partnership for Hospice Innovation (NPHI), National POLST Task Force, Pew Charitable Trusts, Social Work Hospice & Palliative Care Network, Third Way, and Visiting Nurses Associations of America.
The Patient Choice and Quality Care Act:
- Establishes an advance illness care and management Medicare model, which would test new ways to enable individuals to voluntarily engage in a team-based planning process designed to align the care a patient receives with his or her goals of care, values, and preferences. Members of an interdisciplinary team would work together to meet the physical, medical, psychosocial, emotional, and spiritual needs of the patient and caregivers by providing important information and services.
- Provides grants for increasing public awareness of advance care planning and advance illness care by appropriating $50 million for a public education campaign.
- Enhances Medicare’s existing coverage of advance care planning services by allowing appropriately trained or experienced clinical social workers to provide advance care planning services, and ensuring that costs are not a barrier to patients using these services.
- Facilitates increased coordination and alignment between the public and private sector through quality measures, which includes a review of current measuring concepts and preferred practices in end-of-life care. It also requires the National Institute of Health to conduct a study regarding the development of measures related to key gaps, such as ensuring that care aligns with patient wishes, to better understand the population that would benefit from palliative care and advance care planning, and decide the appropriate transitions to hospice. The holistic review culminates in an annual study issued by the Secretary of Health and Human Services.
- Improves of policies related to the use and portability of advance directives and portable orders by requiring Medicare providers of services and entities to follow individuals’ preferences, regardless of the state or site of care.
- Sets-up an Advance Care Planning Advisory Council to advise the HSS Secretary on these issues and institutes additional requirements for facilities to assure that care plans made while an individual receives care are appropriately documented prior to discharge and sent to appropriate providers and facilities upon discharge.
“AARP is pleased to endorse the bipartisan Patient Choice and Quality Care Act of 2017. We appreciate the bipartisan leadership of Senators Warner (D-VA) and Isakson (R-GA) and Representatives Blumenauer (D-OR) and Roe, MD (R-TN) in sponsoring this legislation to help provide individuals with information about their options to help them make the decisions that are best for them and communicate those choices to others. Importantly for AARP, this legislation recognizes and supports the role that family caregivers often play in providing and coordinating care for their loved ones,” said Joyce A. Rogers, AARP’s Senior Vice President, Government Affairs.
“Persons facing serious illness or approaching the end of life need compassionate, coordinated, patient and family-centered care based on their needs and wishes. This legislation would help ensure that Medicare patients facing serious or life-threatening illness have enhanced access to care planning and coordination of services to ensure patients receive the care they want and need. As our country looks for ways to improve health care quality for persons with serious illness, we commend Sens. Warner and Isakson and Reps. Blumenauer and Roe for working to improve access to patient-centered and coordinated care planning to help us reach this goal,” said Sr. Carol Keehan, DC, President and CEO of the Catholic Health Association of the United States.
"C-TAC applauds the introduction of the Patient Choice and Quality Care Act of 2017. This bipartisan - and bicameral – legislation is a critical step forward to ensure that all Americans with advanced illness receive high-quality, person-centered care that is consistent with their goals, values, and wishes. C-TAC congratulates Senators Warner and Isakson and Representatives Blumenauer and Roe on their leadership to improve advanced illness and end-of-life care and we look forward to working toward the passage of this critical legislation,” said Bill Novelli, Co-Chair of C-TAC’s Board of Directors.
“The American Heart Association thanks Senators Warner and Isakson, as well as Representatives Blumenauer and Roe for leading this bipartisan effort to better support people who depend on Medicare and are confronting chronic illness, including heart disease and stroke,” said American Heart Association CEO Nancy Brown. “Advanced care planning is particularly important for heart failure and stroke patients given the complex and changing nature of these illnesses. Many of these patients, like others facing serious illness, are seeking relief from suffering and a greater sense of control that allows them to cherish time with loved ones and alleviate the burden on their family members, who often act as their primary caregivers. Palliative care helps accomplish these goals by focusing on supporting the patient and their individual needs and wishes, and this bill will help more Americans with heart disease and stroke obtain these critically needed care and services.”
“Individuals with serious and advanced illness are often faced with difficult, complicated or overwhelming health care decisions,” said Edo Banach, NHPCO President and CEO. “This legislation would provide much-needed support to those patients as they traverse the health care system, and would also ensure that their emotional, spiritual and family needs are met. We applaud the Sens. Warner and Isakson, and Reps. Blumenauer and Roe for their leadership on behalf of individuals with serious and advanced illness.”
“The Patient Care and Quality Choice Act is a tremendous step forward in providing access to advanced illness care for Medicare beneficiaries around the country. The National Partnership for Hospice Innovation (NPHI) is thrilled to support this transformative bill and its promotion of high quality, advanced illness care by community-based hospices and other providers,” said Tom Koutsoumpas, President and CEO of National Partnership for Hospice Innovations.
Sens. Warner and Isakson and Reps. Blumenauer and Roe have been longstanding advocates in Congress for improved access and quality of medical care for some of our country’s most vulnerable patients. They have previously introduced legislation to expand advance care planning options.
Additionally, Sens. Warner and Isakson recently introduced a bipartisan bill to improve outcomes for Medicare patients requiring chronic care that unanimously passed the Senate Finance Committee last month.
For more information on this bill, click here.