For People Dying to Talk, It Finally Pays to Listen with Reimbursable Advance Care Planning

Whether at the beginning, middle, or end of life, health care delivery choices abound. Yet only recently have conversations specifically regarding preferences for care at the end of life become a reimbursable intervention, deemed equivalent in importance to a medical procedure. Quite distinct from other procedures, in which expectations for outcomes are explicit and measurable, outcomes have been left intentionally vague for advanced care planning (ACP) conversations. This article will explore the inherent challenges of and opportunities for developing formalized outcomes, methods of measurement, and training to ensure excellence in the performance of ACP conversation procedures. Whether at the beginning, middle, or end of life, health care delivery choices abound. Yet only recently have conversations specifically regarding preferences for care at the end of life become a reimbursable intervention, deemed equivalent in importance to a medical procedure. Quite distinct from other procedures, in which expectations for outcomes are explicit and measurable, outcomes have been left intentionally vague for advanced care planning (ACP) conversations. This article will explore the inherent challenges of and opportunities for developing formalized outcomes, methods of measurement, and training to ensure excellence in the performance of ACP conversation procedures.