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Invited Commentary
March 11, 2019

Advance Care Planning Codes—Getting Paid for Quality Care

Author Affiliations
  • 1Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
  • 2Geriatric Research Education and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, New York
JAMA Intern Med. 2019;179(6):830-831. doi:10.1001/jamainternmed.2018.8105

In 2017, Sudore et al1(p14) developed a consensus definition of advance care planning (ACP) as “a process that supports adults at any age or stage of health in understanding and sharing their personal values, life goals, and preferences regarding future medical care. The goal of ACP is to help ensure that people receive medical care that is consistent with their values, goals, and preferences during serious and chronic illness.” The discussion around ACP has evolved for decades. Originally, efforts focused on documenting advance directives or surrogate decision makers, interventions that alone were not effective.2 Now defined as a process, ACP discussions focus on eliciting patient values based on personal experiences, choosing a proxy that understands their role, and communicating their decisions to family members.3 More than 70% of patients are unable to participate in their own end-of-life care decisions, and values and preferences are known to change over time, so ongoing discussions with patients about their wishes are imperative.4

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