The two major public insurance programsMedicare and Medicaidfinance the vast majority of end-of-life care. Both programs offer a hospice benefit which has several shortcomings including requiring physicians to make a prognosis of a six month life expectancy and insisting that patients give up curative treatmenttwo steps which are difficult for doctors and patients to makeand payment levels that may be too low. In addition quality of care initiatives for nursing homes and hospice sometimes conflict. (Wiener and Tilly 2003)
Evaluate the factors influencing the approach of the National Institutes of Health to creating policy recommendations for improving end-of-life care.
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