A catalyst for better care in the final chapter of life

Our latest step is an investment in advance care planning, starting with our own caregivers. 


RodAt Providence, we have long believed that everyone deserves the best possible care at every stage of life, particularly in the final years. That’s why, in 2008, we began speaking out nationally about the need for every American to have the opportunity to plan in advance – in consultation with their physicians – for the type of care they wish to receive through the end of life.

Nearly eight years later, we are celebrating an important policy milestone: Effective January 2016, Medicare will begin covering advance care planning conversations between physicians and patients and will make advance care planning an optional element in annual wellness visits. It’s a key turning point that supports the true spirit of person-centered care, one that would not have been possible without the perseverance of many individuals.

U.S. Rep. Earl Blumenauer of Oregon took up the cause with us back in 2008 and demonstrated incredible leadership and commitment, ultimately securing bipartisan support in Congress. Christa Shively was also involved from the very beginning, first as an aide to Rep. Blumenauer and today as Providence’s director of federal regulatory affairs and engagement. And Providence physician leaders – from Ira Byock, M.D., to Bob Gluckman, M.D. – have been tireless advocates for the cause, as were so many others at Providence, including our government affairs team.

Yet our journey to improve care through the end of life is far from over. There is still much more work to do, and Providence is more committed than ever. Under the leadership of Dr. Byock, the Providence Institute for Human Caring is working to educate clinicians on what it means to deliver whole person care, especially how to talk with people with incurable illness about their wishes and work with them to make decisions about their treatments. We are also working to make our communities aware of the importance of  advance directives and discussing their wishes with family and physicians in the event they were to become incapacitated and unable to speak for themselves.

A health incentive for advance care planning

But perhaps our boldest move yet is to engage the people who work at Providence through an innovative health incentive. We believe we are the first major employer in the nation to incentivize employees to learn about advance care planning for themselves and their families. By completing a brief online training module on the topic, our caregivers can earn up to $700 toward their health savings or health reimbursement accounts, and so can their covered spouses. That’s up to $1,400 per family.

We believe this education will help our caregivers plan the best possible care for themselves through every stage of life. Just as important, as members of a health care community, it will help each of us understand the process on a personal level so that we are better prepared to support patients and families in expressing their wishes and honoring their advance care plans.

We launched the incentive activity as part of benefits open enrollment this year, and caregiver participation exceeded our expectations. Of all health incentive participants, 93 percent chose to complete the advance care planning training over the alternative of completing a health assessment.

Together, the caregivers of Providence are making a statement about the importance of personal values, preferences and priorities to quality of health care. Collectively, we are moving another step ahead in the quest to make the final years and months of life better for everyone.


Ira and I made this video when he first joined our team in 2014. We had a great conversation about engaging our caregivers in advance care planning. That vision is now becoming a reality thanks to his leadership and to incredible participation from our caregivers.

I challenge every major employer to join the cause

Medicare coverage is one piece of the puzzle. But there is also an important role for other major employers and health systems. I challenge them to join us in this cause. Imagine how much progress we could make together if companies across the country made advance care planning part of their health incentive plans.

If any of my CEO colleagues out there are interested in learning more about how we did it at Providence, feel free to contact Dr. Byock or me. We are both incredibly passionate about this topic, and are more than happy to discuss it with other organizations interested in doing something similar and making a difference on this important issue that affects us all at the most vulnerable time in life.

  1. Rod, this is so important. My family is walking through this now with a much loved family member being diagnosed with a terminal illness. What I’ve learned from hearing Dr. Byock and others has greatly influenced our family conversations and my family member’s planning. This incentive is a gift, not just in monetary supplement, but in making sure we think about and plan for what we all will encounter — end of life. I’m so very grateful for this education and resource, it truly is part of our Mission of “revealing God’s love to all, especially the poor and vulnerable, through our compassionate service” and is easing my family’s way during a difficult journey. Thank you.

  2. This was a great incentive and definitely engaged me. I’ve had several in-depth conversations with my husband, my adult children, and my parents. We’ve discovered feelings and perspectives we didn’t even realize we had. The best thing about these conversations is they aren’t happening during a critical crisis.

    Thank you for the incentive that pushes us to have uncomfortable, but very important, conversations with our family members.

  3. Thanks for taking the initiative in this important milestone in a person’s life planning.