Congress passes telehealth, hospital-at-home in funding bill 
Modern Healthcare; by Michael McAuliff; 3/14/25 
Congress completed work on a government funding bill Friday that modestly trims spending, gives President Donald Trump greater flexibility to cut programs and extends expiring healthcare priorities. In a 54-46 vote, the Senate approved legislation the House passed Tuesday that prevents the partial government shutdown that would have commenced at midnight EDT. ... The "continuing resolution," or CR, funds government operations through fiscal 2025, which ends Sept. 30, and extends and finances key healthcare programs for the same duration. Those include reauthorizing Medicare reimbursements for telehealth and hospital-at-home services, originally authorized during the COVID-19 pandemic; ...

Medicare Payment Advisory Commission [MedPAC] releases report to Congress on Medicare Payment Policy 
Medicare Payment Advisory Commission, Washington, DC; News Release, contact Stephanie Cameron; 3/13/25
Today [3/13/25], the Medicare Payment Advisory Commission (MedPAC) releases its March 2025 Report to the Congress: Medicare Payment Policy. The report presents MedPAC’s recommendations for updating provider payment rates in fee-for-service (FFS) Medicare for 2026, providing additional resources to acute care hospitals and clinicians who furnish care to Medicare beneficiaries with low incomes, and eliminating certain Medicare coverage limits on stays in freestanding inpatient psychiatric facilities. The report reviews the status of ambulatory surgical centers (ASCs), the Medicare Advantage (MA) program (Medicare Part C), and the Part D prescription drug program (Medicare Part D). ... Fee-for-service payment rate update recommendations. ... MedPAC recommends ... payment reductions relative to current law for hospice providers, skilled nursing facilities, home health agencies, and inpatient rehabilitation facilities.  [Click on the title's link to continue reading.]

End-of-life conversations: ‘When they open the door, you have to go in’ 
Oncology Nursing News; video by Pattie Jakel, MN, RN, AOCN; 3/13/25
Oncology nurses have a unique relationship with patients that allows for difficult but essential end-of-life conversations, says expert Patricia Jakel, MN, RN, AOCN. Jakel, one of the editors in chief of Oncology Nursing News, emphasized that following up with patients and ascertaining what answers and support they need comes with the close bonds that oncology nurses form with patients with cancer. ... [Jakel describes:] We play a really important role. And sometimes patients ask us difficult questions, and we have to be prepared for it. I remember a lovely young patient I had, she had 2 little girls, and she was very sick. And things weren’t going well for her in the hospital, and she just—she looked up at me and she said, "Am I dying today?" And I thought, "She’s opening the door. She needs to have this conversation.” [Click here to hear this nurse describe the gentle interaction that unfolded.]
Editor's note: Share this significant, sensitive video/article from Oncology Nursing News with your nurses. What communication education and support do you provide for your nurses? Explore this similar article from Oncology Nursing News, "APPs, Oncologists Work Together for End-of-Life Discussions," 11/2/24.

2 tailwinds shaping hospice growth, care delivery 
Hospice News; by Holly Vossel; 3/14/25 
Rising demand for end-of-life care is pushing hospice growth opportunities to the forefront in value-based reimbursement. More payers in this arena are increasingly recognizing the depth of potential beneficial outcomes when it comes to collaborative hospice partnerships. Swelling aging populations have fueled rising health care costs across the country, with payers and providers alike seeking ways to ensure affordable access and sustainable services. ... “As far as tailwinds for the industry specific to hospice, [it’s] predictions for demographic growth,” [David Jackson, CEO and founding partner of Choice Health at Home] said. “The biggest opportunities for growth [are] talking about vertical integration and how we reach up into the health care system. [It’s] talking about the value that we bring from the perspective of patient care, and then talk about the plans, the payers, the opportunity to enhance their financial outcomes.”

How work in the hospice field differs from hospital work 
Healthcare Business Today; 3/17/25 
... How work in the hospice field differs from hospital work goes beyond the obvious difference in care settings—it reflects a fundamental shift in approach, focus, and philosophy. Hospice focuses on enhancing quality of life, while hospitals often prioritize life-saving interventions. This contrast not only shapes patient care but also defines the role of the medical teams in these environments.

• A Shift in Care Priorities ...
• Longer and Deeper Patient Relationships ...
• Autonomy and Decision-Making ...
• Looking Past the Stigma of Hospice ...
• Closing Thoughts: Hospice work reflects a more intimate, holistic approach to care, shifting away from life-prolonging measures. ...

Editor's note: Calling all leaders, especially Human Resources, Clinical Education, and Clinical Managers and all business leaders who have never worked for a hospice. These distinctions are significant. Ensure that you covering this "fundamental shift" in your hiring (Job Descriptions, interviews); orientation, precepting, and ongoing supervision; best practices, competencies and evaluations in interdisciplinary teamwork; community outreach (too many hospice marketing efforts completely water-down hospice's actuality of dying and death). 

Publisher's Dinner: Leaders of home care firm, hospital systems gather for dialogue on improving patient care 
Cincinnati Business Courier; by Trinity In Home Care; 3/14/25 
The Cincinnati Business Courier in late February brought together the leadership of a leading Southwest Ohio home care agency with leaders of Greater Cincinnati’s hospital and hospice systems. The goal was to connect leaders of two essential aspects of the region’s health care system – inpatient hospital care and home care – to see how they could complement and support each other in delivering patient care and growing as organizations. [Click on the title's link for quotes from various leaders from this Cincinnati area.]

The roots of palliative care: Michael Kearney, Sue Britton, and Justin Sanders
GeriPal - A Geriatrics and Palliative Care Podcast for Every Healthcare Professional; by Alex Smith; 3/13/25
... As far as we’ve come in the 50 years since Balfour Mount and Sue Britton opened the first palliative care at the Royal Victoria Hospital in Quebec, have we lost something along the way? In today’s podcast we welcome some of the early pioneers in palliative care to talk about the roots of palliative care.  Sue Britton was the first nurse hired on that palliative care unit. Michael Kearney on a transformational meeting in Cicely Saunders’s office, with Balfour Mount at her side and a glass of sherry.  Justin Sanders wants to be sure the newer generations of palliative care clinicians understand the early principles and problems that animated the founders of hospice and palliative care, including:

• Origins of the word “palliative” – it’s not what I thought! Yes, it means “to cloak,” but there’s more…
• Whole-person-care
• Total pain
• Healing as a process distinct from the deterioration of the body
• Sympomatologists
• The patient and family as the unit of care

2010 to 2019 saw early palliative care billing up for advanced cancer 
HealthDay News; by Elana Gotkine; 3/17/25 
For patients with distant-stage cancers, there was an increase in early palliative care (PC) billing from 2010 to 2019, but the level remained low, according to a study published online March 7 in the Journal of Clinical Oncology. ... The researchers found that in 2010 to 2019, there was an increase in the percentage with early PC billing among 102,032 patients treated by 18,908 unique physicians, from 1.44 to 10.36 percent. The likelihood of early PC billing was increased in association with treating physician's early PC referrals in the previous year and organizations' employment of any HPM specialist (3.01 and 4.54 percentage points, respectively). 

Less wealth at death linked to more end-of-life symptoms 
McKnights Long-Term Care News; by Kristen Fischer; 3/10/25 
Older people with less wealth showed a higher burden of symptoms when they approached the end of their lives compared with those who had more wealth, a study found. The report was published in JAMA Network Open on March 6. Investigators looked at data from 8,976 older adults. The team evaluated 12 end-of-life symptoms including difficulty breathing, frequent vomiting, low appetite, difficulty controlling arms and legs, depression, and severe fatigue or exhaustion.Then they correlated symptoms to individuals’ wealth. Wealth was broken into three categories: low wealth was having less than $6,000; medium wealth was having between $6,000 and $120,000; and high wealth was considered having more than $120,000 at the time of death. Of respondents, 22.5% had low wealth, 50.5% had medium wealth and 27.1% had higher wealth. People who had less wealth were more likely to have a higher burden of symptoms compared to those who had more money. Functional impairment, multimorbidity and dementia were factors that affected the association, data revealed.
Editor's note: Click here for this important JAMA article, posted in our Saturday Research issue 3/15/25, "Wealth disparities in end-of-life symptom burden among older adults."

Pharmacies of the future: 4 keys to reinvention
Forbes; by Jenn Vande Zande; 3/11/25
... “To continue to meet growing patient needs, we must evolve how community pharmacy works and, most importantly, how we support our pharmacy teams to create a sustainable future for community pharmacy,” Prem Shah, president of pharmacy and consumer wellness at CVS Health, said, referring to findings from the company’s Rx Report from January 2024. Based on those findings, CVS says there’s a “critical need for sustainable and scalable industry-wide change, such as operational improvements and digital innovations to better support pharmacy teams behind the counter.” Here are four focus areas for pharmacies to bring about that change:

1. Reinventing the brick-and-mortar business model. ...
2. The digital infrastructure to deliver a superior CX. ...
3. AI. ...
4. More sophisticated training to support pharmacists as they play a larger role in patient care. ... 

Where are all the nurses? Data show that some states have a far higher number of nurses per capita than others
Medscape; by Jodi Helmer; 3/7/25 
During their 12-hour shifts, registered nurses (RNs) in Arizona and Arkansas perform many of the same tasks as RNs in Wisconsin and Wyoming: Assessing patients, monitoring vital signs, administering medications, and charting records to provide the best patient care. The work might be similar, but there are vast differences in the number of RNs in each state. ...  Even states with the largest number of nurses per capita are not immune to the nursing shortage. The National Bureau of Labor Statistics estimates that there will be 195,400 job openings for RNs from 2021 to 2031.  ....

• States With the Highest Number of Nurses Per Capita: South Dakota ... District of Columbia ... North Dakota ...
• States With the Lowest Number of Nurses Per Capita: Nevada ... Utah ... Idaho ...

[Click here for data.]

What Trump has done with Medicare so far 
Kiplinger; by Kathryn Pomroy; 3/17/25 
Since President Trump was sworn into office on January 20, he has proposed or initiated changes impacting Medicare. Here's a roundup. ...

• Trump taps Robert F. Kennedy, Jr. to head the HHS ...
• Trump taps Dr. Mehmet Oz to lead the CMS ...
• Medicare and Medicaid employees offered buyouts ...
• The Administration cancels some payment trials ...
• Trump pauses hospice industry oversight ...
• OMB steps back funding freeze of Medicare grants and loans ...
• Trump reverses Biden’s prescription drug price caps ...
• The Administration gives DOGE the green light ...
• Republicans' new funding bill ... 

Penny Stamps speaker Gary Tyler shares his wrongful conviction story, empowers communities through art
The Michigan Daily; by Talia Varsano; 3/17/25
At 5:30 p.m. in the Michigan Theater Thursday night, nearly every seat was full as the audience welcomed Gary Tyler, a falsely convicted felon of first-degree murder turned artist, performer, youth mentor and community leader. ... On October 7, 1974, Tyler was framed and wrongfully convicted by an all-white jury of first-degree murder and sentenced to death at 16 years old. ... At the event, Tyler spoke about his experience as an inmate at the Louisiana State Penitentiary in Angola for nearly 42 years before his release in 2016. Tyler said the trajectory of his life was completely shifted by his wrongful imprisonment. ... [Tyler's story of imprisonment continues.] Tyler began quilting while incarcerated to raise money for the hospice program at Angola, which provided end-of-life care for Louisiana State Penitentiary inmates. Tyler said he was inspired by his mother and grandmother, who were also quilters, as well as the communities surrounding him. ... Tyler said. “When I do quilts, I try to pull everything around me, because I try to build, I try to put everything that I feel, that someone would identify, someone would recognize, understand, in my quilt.” ... Tyler volunteered for the Angola Prison Hospice program for more than 17 years while incarcerated.
Editor's note: Pair this with "Death and redemption in American prison," posted 2/19/24 about Gary's friend and fellow quilter at Angola Prison Hospice program, Stephen Garner. 

[International] Healthcare on the brink: Palliative Care Unit and Late Shift 
The 75th Berlin International Film Festival - Part 7, wsws.org; by Martin Nowak and Bernd Reinhardt; 3/16/25 
Two films, the drama Late Shift (Heldin) and the documentary Palliative Care Unit (Palliativstation), featured at this year's Berlin International Film Festival, addressed the current situation in German and Swiss hospitals. The sold-out festival screenings reflected the burning public interest in this topic. This is particularly remarkable bearing in mind that Palliative Care Unit has a running time of more than four hours. ... [In the] documentary Palliative Care Unit by Philipp Döring, shot at the Franziskus Hospital in Berlin, ... [the] camera quietly observes the daily routine, staff consultations and the constant empathy of the head of the ward towards employees and seriously ill patients, who usually spend their last weeks here. The very calm, always discreet images emphasise the necessity of sufficient time for care and reflection when making life-critical decisions. ... How can the highest possible quality of life be achieved? The high ethical standard of treating incurable patients as active human beings ... is admirable and makes a lasting impression throughout the film.

You are today where your thoughts have brought you; you will be tomorrow where your thoughts take you. ~ Paulo Coelho