title: A new medicare end-of-life benefit for nursing home residents.
abstract: Many elderly people spend their final days in nursing homes. For them, high-quality end-of-life care is an important component of their overall care. Unfortunately, the Medicare hospice benefit-the primary source of palliative care coverage for Medicare beneficiaries-is a poor fit with the nursing home setting. We recommend creating a separate end-of-life Medicare benefit for nursing home residents based on documented need for services that neither requires physicians to certify a person's prognosis, nor requires beneficiaries to choose it or to agree to forgo curative care. Nursing homes would be paid directly for end-of-life care services and held accountable for their quality.
authors.affiliation: Harvard Medical School, Boston, Massachusetts, USA. huskamp@hcp.med.harvard.edu
authors.forename: Haiden A
authors.initials: HA
authors.lastname: Huskamp
authors.forename: David G
authors.initials: DG
authors.lastname: Stevenson
authors.forename: Michael E
authors.initials: ME
authors.lastname: Chernew
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Newhouse
mesh_terms: D000369:Aged, 80 and over; D005260:Female; D006299:Health Services for the Aged / Q000191:economics / Q000331:legislation & jurisprudence; D017051:Hospice Care / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D006278:Medicare / Q000191:economics*; D009735:Nursing Homes / Q000191:economics / Q000706:statistics & numerical data*; D010043:Outcome and Process Assessment, Health Care / Q000379:methods; D011788:Quality of Life; D012051:Reimbursement Mechanisms; D013727:Terminal Care / Q000191:economics; D014481:United States