Blue Cross and Blue Shield of Massachusetts will begin offering some of the most comprehensive end-of-life benefits in the nation, reports the Boston Globe.

Effective Jan. 1, BCBS Massachusetts will expand access to hospice services and will pay for more counseling sessions between providers and patients to discuss end-of-life care. BCBS will also cover the costs of visits to psychologists and other mental health workers to discuss how they want to experience their last living days and whether to forego intensive medical treatments to be more comfortable in the end.

“The industry is now starting to take this seriously,” Dr. Lachlan Forrow, director of the ethics and palliative care programs at Beth Israel Deaconess Medical Center, told the Globe. “The industry now not only understands the issues [around death and dying], but understands there are concrete things they can and need to do, and Blue Cross is showing us how to get started.”

According to the Globe, the move was inspired by BCBS Massachusetts CEO Andrew Dreyfus’ experience with the death of his parents and 61 year old brother, detailed in a recent essay he wrote for the Globe.

“Each of these losses was excruciating, but my grief was softened because my parents and brother made decisions about their care and died gently, free from invasive medical treatment and touched by loved ones until the very end,” Dreyfus wrote. “Unfortunately, their experiences are not typical.”

The insurer is also developing a home care program to be launched later this year.

Our Take: While BCBS Massachusetts isn’t the first payer to cover end-of-life counseling, it may be the largest, with 2.2 million members.

In 2016, we expect to see an increased emphasis on end-of-life care from ACOs and health systems, as well as increased use of home care and home hospice services. Medicare will begin reimbursement for end-of-life care discussions between providers and patients this year.

A 2010 study found that 25% of all Medicare expenses occur in the last year of life—an amount unchanged in a generation despite changes in the delivery of medical care. Better decision making around end-of-life care decisions could mean lower costs and better, more compassionate care for patients.


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