(AP photo/Dr. Scott M. Lieberman)

The U.S. health care system often puts dying patients and their families through a maze of care services and settings without providing much financial or emotional support.

Carmella Bocchino, an executive vice president at America’s Health Insurance Plans (AHIP), and Dr. Randall Krakauer, a vice president at Aetna (NYSE:AET), were two of the witnesses who talked about the bureaucracy and confusion that face dying patients today at a hearing on advanced care planning organized by  the Senate Special Committee on Aging.

Krakauer urged senators to improve end-of-life benefits for patients in Medicare Advantage plans by changing the rules that govern use of hospice benefits.

Medicare managers should let enrollees who seem to have as many as 12 months to live use hospice benefits, Krakauer said.

Today, the cut-off is six months.

Medicare also should let more patients get the emotional support hospice programs provide by letting patients get hospice treatment along with hospice, Krakauer said.

Aetna already provides those program rules for commercial health plan enrollees who appear to have fewer than 12 months to live, and, for those patients, it also provides coverage for an unlimited number of hospice inpatient days and eliminate outpatient hospice dollar limits, Krakauer said.

Family members get 15 days of respite care and bereavement services.

The program increases the percentage of patients who use hospice, improves their level of satisfaction, and reduces use of acute medical care services, Krakauer said.

Krakauer said Aetna also supports the idea of including measures of the quality of end-of-life care in Medicare plan quality ratings. 

“We believe that measuring health plans’ progress in caring for members with advanced illness helps ensure that individuals and their families receive the compassion and support that is critically important at the end of life,” Krakauer said, according to a written version of his testimony.

Bocchino testified that AHIP is working with a wide range of stakeholders, including employers and health care providers, to develop proposals for improving management of care for people with advanced illness.

The members of the team will try to develop proposals for eliminating unreasonable program eligibility criteria and artificial benefits boundaries that affect where patients can get certain types of care, Bocchino said. 

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