Federal Advance Care Planning Policy Primer - Key Aspects, Barriers, and Opportunities

Area of Science:

• Health Policy
• Medical Ethics
• Gerontology

Background:

• Advance care planning (ACP) involves patients defining future medical care goals and preferences.
• Systematic reviews show inconsistent associations between ACP and goal-concordant care, advance directive completion, and healthcare utilization.
• Despite mixed evidence, ACP is valued by patients and clinicians, with ongoing policy advancements at state and federal levels.

Purpose of the Study:

• To provide an overview of federal policy aspects influencing Advance Care Planning (ACP).
• To identify key barriers hindering the effective delivery and utilization of high-quality ACP.
• To highlight opportunities for improving federal ACP policy.

Main Methods:

• Policy analysis of federal legislation and regulations impacting ACP.
• Review of existing literature on ACP effectiveness and implementation challenges.
• Identification of specific policy-related barriers such as Medicare billing codes, telemedicine access, interoperability, and program measures.

Main Results:

• Federal policies have promoted ACP awareness but face challenges in incentivizing and facilitating high-quality delivery.
• Key barriers include limitations in Medicare ACP billing codes, telemedicine disparities, advance directive interoperability issues, and underutilization in federal programs.
• Despite challenges, federal and state policies underscore the importance of ACP in healthcare.

Conclusions:

• Federal policy improvements are crucial for enhancing ACP delivery and utilization.
• Clinicians must be informed about policy nuances to effectively engage in ACP.
• Addressing identified barriers can lead to better integration of ACP into routine medical care, supporting patient-centered outcomes.