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Americans express strong views when asked about the care that they want to receive when they are dying. In general, they prefer to die at home and to remain in charge of decisions about their care. However, evidence suggests these wishes are not likely to be fulfilled.
Last month, the Institute of Medicine (IOM) published their much-awaited report titled “Variation in Health Care Spending: Target Decision Making, Not Geography,” which recommends that CMS (Centers for Medicare and Medicaid Services) should not adjust Medicare payments geographically; instead, CMS should continue to focus on value-based payment reforms, such as patient-centered medical homes, bundled payments, and accountable care organizations.