By 1996, eighty-five per cent of La Crosse residents who died had written advanceddirectives, up from fifteen per cent, and doctors almost always knew of and followed the instructions.
The momentum is leading medical care providers to integrate end-of-life care and advanceddirectives into their ACOs, which gather doctors and other caregivers under one umbrella and are paid by Medicare and private insurers to treat groups of patients.
While the Obama administration defended the legislation, opposition to such reimbursement kept Medicare payment to doctors who bill specifically for discussing advanced-directives and related end-of-life counseling out of the Affordable Care Act.