title: Recommendations to improve end-of-life care through regulatory change in U.S. health care financing.
abstract: Palliative care has emerged as the interdisciplinary approach to relieving suffering and improving quality of life. Unfortunately, it is not yet available to all who need it. Although legislation may ultimately be needed, regulatory changes can quickly improve the current situation. While we see many regulatory changes that are possible, just three would quickly improve care: adjust hospital payment to include essential palliative care services for hospitalized patients in pertinent Diagnostic Related Groups (DRGs); clarify physician payment for providing palliative care by clarifying guidelines for carriers and paying for case management services; and clarify the Medicare Hospice Benefit by defining the 6 month prognosis in statistical terms.
authors.affiliation: Center for Palliative Studies, San Diego Hospice, San Diego, California 92103-1407, USA. cvongunten@sdhospice.org
authors.forename: Charles F
authors.initials: CF
authors.lastname: von Gunten
authors.forename: Frank D
authors.initials: FD
authors.lastname: Ferris
authors.forename: Robert
authors.initials: R
authors.lastname: D'Antuono
authors.forename: Linda L
authors.initials: LL
authors.lastname: Emanuel
mesh_terms: D003953:Diagnosis-Related Groups / Q000145:classification; D006297:Health Services Accessibility / Q000191:economics*; D017051:Hospice Care / Q000191:economics* / Q000331:legislation & jurisprudence / Q000592:standards; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D006278:Medicare / Q000331:legislation & jurisprudence*; D011379:Prognosis; D012051:Reimbursement Mechanisms / Q000331:legislation & jurisprudence*; D014481:United States