MONEY

End-of-life care services growing in Nashville

Alex Tolbert
Special to Nashville Tennessean / USA TODAY NETWORK – TENNESSEE
Advance care plans become effective when patients can no longer make decisions for themselves, and are very helpful to family members having to make difficult choices on a loved one’s behalf.

Well-known Nashville business leaders — and one famous country singer — are throwing their weight behind the palliative care industry.

Palliative care is specialized medical treatment for patients with serious illnesses. Services can include treatment, care management and helping patients and families navigate the complicated health care industry during the end-stages of an illness.

Aspire Health, founded in 2013 by former Senate Majority Leader Bill Frist and Brad Smith, and Narus Health, founded last year by former Entrepreneur Center CEO Michael Burcham, are both tackling the complicated nature of end-of-life treatment.

The companies aim to address an often-overlooked part of the health care ecosystem in a way that can improve quality of life while also lowering costs.

Both companies have grown notably as the need for palliative care increases. Clinical company Aspire Health has grown from 60 employees to more than 250 in the past year, and care coordination company Narus Health just added a big name to its board with the addition of Tim McGraw in April.

Aspire and Narus fill a gap in the industry as more people — both ill and healthy — begin advance care planning to discuss their end-of-life wishes. These advance care plans become effective when patients can no longer make decisions for themselves, and are very helpful to family members having to make difficult choices on a loved one’s behalf.

How do advance care plans work?

In Tennessee, the state Department of Health has an official document outlining end-of-life wishes. The advance care directive specifies which treatments a patient would want to receive in the case that recovery from illness or injury is unlikely.

Patients in treatment for end-stage illnesses could receive CPR in the case of a heart attack, or antibiotics if a new infection develops. But some people prefer not to receive aggressive medical treatment in the end stages of life, and others might prefer to receive treatment as long as medically possible. Advance care plans make sure family members and physicians are aware of a patient’s wishes in these and other cases.

Who should have advance care plans?

Typically, older patients and those facing serious illnesses are more likely to have advance care plans. These are the types of patients that Narus Health or Aspire Health might work with and treat.

But advance care plans can be beneficial for all people, regardless of age and health status. Accidents and illness can strike at any time, and having the chance to specify your treatment wishes while healthy can ease the burden on family members.

Most physicians recognize the importance of advance care plans. A survey conducted by the John A. Hartford Foundation found that 99 percent of physicians say having conversations about advance care plans is important, but most providers aren’t sure how to broach the discussion. Beginning this year, Medicare began reimbursing physicians for having these conversations with patients, but so far, less than a third have actually done so.

Nearly half of the surveyed physicians said they sometimes feel unsure of what to say when discussing advance care planning. Discussing illness, mortality and end-of-life care can certainly be an uncomfortable and painful conversation, but leaving friends and family to make difficult choices for you can be much worse.

How do you get an advance care plan?

National Healthcare Decisions Day works to educate consumers about advance care planning, and a national organization called “Death Over Dinner” provides detailed instructions on how to initiate these conversations.

The new Medicare reimbursement should also incentivize more physicians to broach the topic with patients, but Tennessee consumers don’t need to visit a doctor to fill out an advance care directive.

The necessary documents are available through the state’s Department of Health website, and many lawyers can help clients with these forms. In conjunction with National Healthcare Decisions Day, Bernard Health also launched an advance care planning service. People can visit a Bernard Health store to speak with a certified facilitator who will moderate the planning process.

It’s never too early to consider your end-of-life wishes. Hopefully, the efforts of advance care planning supporters and palliative care companies like those in Nashville can encourage more patients and consumers to have these discussions.

Alex Tolbert is the founder of Bernard Health, a company that provides non-commissioned, expert advice on health, Medicare and COBRA insurance and medical bill consulting. To learn more about Bernard Health, visitwww.bernardhealth.com.