Conversation Starters: Research Insights from Clinicans and Patients on Conversations about End-of-Life Care and Wishes

The John A. Hartford Foundation, Cambia Health Foundation, and California Health Care Foundation commissioned PerryUndem Research/ Communication to conduct focus groups among health care clinicians and patients on the topic of end-of-life care and wishes.This qualitative research comes on the heels of a national survey we conducted in spring 2016 among primary care providers and specialists who regularly see patients 65 and older. The national survey showed that nearly all physicians consider advance care planning conversations important, while, as of early March 2016, only a fraction had billed Medicare for such conversations using a new Medicare reimbursement code implemented in January 2016.The national survey identified key barriers to having these conversations, such as not having a formal assessment process in place, feeling uncertain about what to say in conversations with patients, feeling unsure when to have the conversations, and having difficulty dealing with family disagreements.The goal of the qualitative research was to explore experiences and ideas from both clinicians and patients around starting and having quality conversations about advance care planning and end of life. This qualitative research focused on various types of clinicians in contrast to the spring 2016 national survey, which only included primary care physicians and specialists