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Facilitating Advanced Care Planning Using Mortality Risk Assessment

As America’s population ages, advanced care planning is becoming an essential component of primary care. The Center for Medicare and Medicare Services recognized this fact in 2015, when it authorized two new billing codes that allow physicians and other health professionals to bill Medicare for advance care planning as a separate service beginning Jan. 1, 2016. Nevertheless, the question of when and how to open the dialogue about end-of-life planning between patients and practitioners remains largely unresolved.

Nurse with elderly patient

Nurse with elderly patient

Now, a small study shows how the use of a mortality risk assessment can facilitate advanced care planning and help elderly and chronically ill patients and their families make informed decisions about end-of-life care. The study was published in the Journal of the American Association of Nurse Practitioners on Oct. 25, 2015.

Impact of MRA on Advanced Care Planning

A mortality risk assessment assists healthcare professionals in determining a person’s risk of death during the next six to 12 months. It includes multiple factors, including the patient’s:

  • Age
  • Gender
  • History of chronic illness (chronic obstructive pulmonary disease, chronic kidney disease, congestive heart failure, dementia and cardiac arrhythmia)
  • History of recurrent infections
  • Multiple hospitalizations or ER visits
  • History of intubation
  • Functional status
  • Body Mass index
  • History of unintended weight loss

The study included 87 patients (mean age 81) who had recently been admitted to a nursing home. Patients were assigned a risk category (low, moderate or high) based on their MRA scores.

Read more about this article here.

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Floyd Arthur

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