Medicaid expansion helps all have access to end-of-life planning | Editorial

A medical document with the unwieldy acronym POLST may be your ticket for assuring that your final days play out the way you’d like them to.

The letters stand for Practitioner Orders for Life Sustaining Treatment, and in plain English, they let healthcare providers know what measures – if any – you would like followed if you are unable to communicate your wishes yourself.

Now officials with the state Department of Human Services are taking a new look at these directives and other end-of-life matters in hopes of improving patient care.

Last week they announced they will expand Medicaid coverage for advanced care planning, which has important implications for the 1.7 million low-income residents who depend on the federal health-insurance program.

The move follows similar efforts by DHS, which oversees Medicaid, to look beyond traditional doctor visits to cover such services as diabetes education and smoke-cessation programs.

Electronic POLST puts end-of-life wishes in the patient’s hands

It’s also a response to organizations such as the New Jersey Health Care Quality Institute, which has been pushing the state to focus its energies on better informing Garden State residents about the options available as the end of life nears.

The organization seeks more robust funding for palliative care services, an approach that focuses on keeping patients comfortable and pain-free during life-threatening illnesses.

It also advocates paying physicians higher rates for end-of-life consultations, conversations too few doctors are trained to enter into.

Ninety-nine percent of physicians taking part in a recent national poll said these discussions are necessary, but fewer than one-third of them said they had received any formal training on conducting them.

Only 14 percent said they billed for such a consultation.

Making patients aware of the POLST forms, which are available online on the Department of Health website, is a valuable step as New Jersey’s population ages.

Signed by both the doctor and the seriously ill patient, the document spells out preferences about such life-saving procedures as cardiopulmonary resuscitation, mechanical ventilation, intubation and artificially administered nutrition.

At its simplest, the form helps a patient avoid unwanted medical intervention, while providing peace of mind for family members seeking guidance during a tense and emotion-laden time.

While the POLST forms aren’t new – former Gov. Chris Christie signed legislation authorizing their use in 2011 – what is new are efforts to develop an electronic system for storing the information in a database that will be immediately accessible to hospitals and health-care providers statewide.

Putting a priority on end-of-life strategies is a welcome development, one that will not only help reign in medical expenditures over the long run, but also serve as a source of comfort to the state’s patients and their loved ones.

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