To the Editor: In their Perspectives on Care at the Close of Life article, Drs Harrington and Smith1 discussed the role of chemotherapy at the end of life and made a few suggestions about how to reduce the cost of oncology care. It is also important to consider that delays in reimbursement and low reimbursement for counseling (relative to the time it takes) contribute to fewer physicians initiating more patient and family meetings to establish the goals of care. Medicare reimbursement for prolonged services with direct patient contact may be delayed up to 1 year or denied.
Hilty SA. Reimbursement for Patient and Family Meetings and the Costs of Care at the End of Life. JAMA. 2008;300(18):2119-2120. doi:10.1001/jama.2008.549