Utilization of ACP CPT codes among high-need Medicare beneficiaries in 2017: A brief report

Medicare beneficiaries with high medical needs can benefit from Advance Care Planning (ACP). Medicare reimburses clinical providers for ACP discussions, but it is unknown whether high-need beneficiaries are receiving this service. To compare rates of billed ACP discussions among a cohort of high-nee...

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Bibliographic Details
Published in:PloS one 2020-02, Vol.15 (2), p.e0228553-e0228553
Main Authors: Reich, Amanda J, Jin, Ginger, Gupta, Avni, Kim, Dae, Lipstiz, Stuart, Prigerson, Holly G, Tjia, Jennifer, Ladin, Keren, Halpern, Scott D, Cooper, Zara, Weissman, Joel S
Format: Article
Language:English
Subjects:
Advance Care Planning - standards
Advance Care Planning - statistics & numerical data
Advance directives
Age
Aged
Aged, 80 and over
Beneficiaries
Biology and Life Sciences
Chronic illnesses
Chronic kidney failure
Chronic obstructive pulmonary disease
Codes
Comorbidity
Current Procedural Terminology
Disability
Diseases
Fee-for-Service Plans - statistics & numerical data
Female
Frailty
Government programs
Health care policy
Health Expenditures - statistics & numerical data
Hispanic people
Hospitals
Humans
Kidney diseases
Legal fees
Male
Medicare
Medicare - statistics & numerical data
Medicine
Medicine and Health Sciences
Minority & ethnic groups
Patients
Population
Public health
Retrospective Studies
Social Sciences
Subgroups
Surgery
United States
Womens health
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Description
Summary:Medicare beneficiaries with high medical needs can benefit from Advance Care Planning (ACP). Medicare reimburses clinical providers for ACP discussions, but it is unknown whether high-need beneficiaries are receiving this service. To compare rates of billed ACP discussions among a cohort of high-need Medicare beneficiaries with the non-high-needs Medicare population. Retrospective analysis of Medicare Fee-for-Service (FFS) claims in 2017 comparing high-need beneficiaries (seriously ill, frail, ESRD, and disabled) with non-high need beneficiaries. Nationally representative FFS Medicare 20% sample. Medicare beneficiaries were assigned to one of the following classifications: seriously ill (65+), frail (65+), seriously ill & frail (65+); non-high need (65+); end stage renal disease (ESRD) or disabled (
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0228553