From the Kaiser Foundation
About three-quarters of the 2.5 million people who die during the year in the US are ages 65 and older, making Medicare the largest insurer of health care provided during the last year of life.1 In fact, roughly one-quarter of traditional Medicare spending for health care is for services provided to Medicare beneficiaries in their last year of life—a proportion that has remained steady for decades.2 The high overall cost for health care received in the last year of life is not surprising given that many who die have multiple serious and complex conditions.
Aside from cost, several other factors contribute to difficult clinical and policy discussions about whether patients are getting the care they want or need as they approach the end of their lives. Research has found, for example, that most adults (90 percent) say they would prefer to receive end-of-life care in their home if they were terminally ill, yet data show that only about one-third of Medicare beneficiaries (age 65 and older) died at home.3
Starting in 2016, Medicare will begin covering advance care planning—discussions that physicians and other health professionals have with their patients regarding end-of-life care and patient preferences—as a separate and billable service. The following 10 FAQs provide information on Medicare’s role in end-of-life care and advance care planning. In addition to defining relevant terms, and explaining Medicare’s current and future coverage for end-of-life care, these FAQs also describe recent relevant rules released by the Administration and additional proposals from Congress regarding advance care planning and care for people with serious and terminal illness.