When Policy Meets the Realities of Care

Why the MAP for Care Act Matters

By Scott Brown
President & CEO, MyDIrectives

Advance care planning (ACP) is a critical component of quality healthcare. It helps patients, families, and care teams navigate some of the most complex and consequential decisions in medicine. Without proper ACP documents, the result’s often confusion and stress for physicians, family strife during already difficult moments, and unnecessary, non-beneficial care for patients.

But here’s the catch: ACP only works when the process is built for clinical reality, the resulting decisions are accessible, and the documents are interoperable. That’s why we’re proud at MyDirectives to support the Medicare Advance Planning (MAP) for Care Act, introduced by Senators Bill Cassidy (R-LA) and Chris Coons (D-DE), which recognizes a simple but critical truth: planning ahead only matters if those plans are available whenever and wherever care decisions are made.

Too often, advance directives are completed with the best of intentions, then they’re lost, inaccessible, or unavailable in moments of crisis. The MAP for Care Act directly addresses this gap by focusing on electronic advance directives that can follow a person digitally across care settings.

ACP only works when advance directives and portable medical orders are accessible in real time to clinicians and first responders, particularly during emergencies and transitions of care. The MAP for Care Act aligns the country around standards that already exist to help ensure every person’s voice can be heard, respected, and actionable when it matters most.

Why This Legislation Is Different

What makes the MAP for Care Act especially important is its recognition that ACP must move beyond paper-based processes and fragmented storage. PDFs in patient portals, documents kept at home, or forms buried in filing cabinets don’t help families or care teams during emergencies.

This isn’t a new lesson. That’s why, at MyDirectives, this has been our work for nearly two decades.

Today, MyDirectives operates the nation’s only HIPAA compliant, HITRUST and TX-RAMP certified, and SOC 2 Type II audited advance directive and POLST registry designed for 24/7 real-world clinical and emergency first responder access. Our platform supports the secure creation, storage, sharing, and retrieval of advance directives, mental health advance directives, and portable medical orders across EHRs, EMS and other first responders, hospitals, and state lines.

What the MAP for Care Act seeks to accomplish isn’t theoretical. The infrastructure it envisions already exists and has been in active use for almost 15 years.

From Intent to Action

Through real-world implementation, we’ve seen firsthand what happens when ACP documents are accessible and actionable:

• Improved alignment between patients, families, and clinicians
• Fewer unwanted or non-beneficial interventions and hospitalizations, accompanied by a significant decrease in associated costs
• Greater dignity, autonomy, and informed decision-making
• A healthcare system better equipped to deliver compassionate, goal- and order-concordant care while simultaneously reducing fraud, waste, and abuse

When families and clinicians are forced into crisis because advance directives or portable medical orders can’t be located or verified, the results are confusion, moral distress, unnecessary interventions, and billions of dollars in avoidable waste. The MAP for Care Act takes an important step to help ensure Medicare beneficiaries receive care that aligns with their goals, while also helping the healthcare system more reliably access and act upon those care preferences.

The bill focuses on Medicare beneficiaries, a population where serious illness planning, care transitions, and complex medical decision-making are especially common. By starting here, the MAP for Care Act establishes a scalable model for how ACP can be modernized across the healthcare system.

Aligning Policy With What Already Works

Americans value dignity and the ability to direct their own lives, especially during serious illness. The MAP for Care Act reinforces that principle by empowering individuals and their families, helping Medicare beneficiaries take personal responsibility for documenting care preferences in ways that are secure, valid, and accessible when needed, while also giving care teams the clarity they need to honor what matters most.

Just as importantly, the bill recognizes the essential role of technology in making this possible. If we’re going to fulfill the promise of modern ACP, we have to leverage technology and make advance directives, mental health advance directives, and portable medical orders immediately accessible across all care settings. That’s why MyDirectives is proud to support a framework that brings the federal government into alignment with best-in-class technology.

Moving Forward

This bill speaks directly to why MyDirectives exists and why I founded the company nearly 20 years ago.

Too many families have experienced the pain of not knowing a loved one’s wishes, or, more troubling still, having those wishes ignored because the document couldn’t be found or trusted. The MAP for Care Act offers a bipartisan path forward that brings clarity, compassion, and modern infrastructure to ACP for Medicare beneficiaries nationwide.

We applaud Senators Cassidy and Coons for their leadership and are immensely proud to support legislation that puts patients’ goals, values, and preferences at the center of care, where they belong. We’re honored to help translate this vision into reality, not in theory but in practice, by helping ensure advance directives, mental health advance directives, and POLST forms can be created, accessible, and actionable across all care settings, exactly when and where care decisions are made.

About the Author
Scott Brown is President and Chief Executive Officer of MyDirectives, a leader in digital advance care planning. He co-founded the company in 2007 with a deeply personal mission: to ensure his mother, who had been diagnosed with multiple sclerosis, could have her voice heard and respected at the end of her life. That vision continues to guide MyDirectives as it helps people document, share, and access their care preferences anytime and anywhere.

A strong advocate for interoperability and person-centered care, Scott is co-editor of the HL7 CDA® R2 Implementation Guide: Personal Advance Care Plan Document and a reviewer of the HL7 CDA® R2 Implementation Guide: C-CDA R2.1 Revised Templates for Advance Directives. His work contributes to national standards that make care preferences more accessible and actionable across the healthcare system.

Before founding MyDirectives, Scott practiced international corporate, securities, and M&A law in Paris and Dallas. He earned his undergraduate degree with distinction from the University of Oklahoma, graduating Phi Beta Kappa, and received his Juris Doctor from Tulane Law School.