Literature Review

MedPAC releases June 2024 report on Medicare and the health care delivery systemMedPac - Medicare Payment Advisory Commision; Press Release; 6/13/24The Medicare Payment Advisory Commission (MedPAC) released its June 2024 Report [on June 13, 2024] to the Congress: Medicare and the Health Care Delivery System. Each June, as part of its mandate from the Congress, MedPAC reports on improvements to Medicare payment systems, issues affecting the Medicare program, and changes to health care delivery and the market for health care services. This year’s report covers the following topics:

Revenue pressures driving home care consolidation, private equity’s growing influence, provider group saysMcKnight's Home Care; by Adam Healy; 6/11/24Pressures such as insufficient government reimbursement and rising Medicare Advantage penetration are contributing to consolidation in home care and hospice, LeadingAge told regulators last week in response to a February request for information surrounding healthcare market competition. “Sustainable fee-for-service rates that cover the continually rising costs of delivering care are of critical importance,” LeadingAge said. “Outside revenue pressures such as lower reimbursement rates from managed care plans, reduced units of service through accountable and managed care organizations, and an increasing need to be an organization of a certain size in order to contract with managed care organizations and accountable care organizations are also factors that drive consideration of consolidation options.” One particular concern, LeadingAge noted, is the growing investment in healthcare by private equity firms. Private equity firms have driven a significant share of home care and hospice consolidation in recent years. PE firms had a hand in 35 home health deals, 15 personal care deals and 13 hospice deals last year, according to a recent report. And studies have shown that patients receiving care from PE-owned providers may experience worse health outcomes than patients at nonprofit agencies.

Misconceptions about palliative care still abound, two experts assertMcKnight's Home Care; by Liza Berger, Brynn Bowman, Allison Silvers; 6/12/24[Podcast] While awareness has grown, a sound understanding of palliative care — specialized medical care for people living with serious illnesses — still lacks among the general public and among physicians and other healthcare professionals. The misconceptions present a barrier to its wider use, according to Brynn Bowman, CEO, and Allison Silvers, chief healthcare transformation officer, of the Center to Advance Palliative Care, who spoke to McKnight’s Home Care in a Newsmakers podcast. Among the many myths is that palliative care is not paid for; it is a service under Medicare Part B, they clarified.

Spousal caregivers need emotional support before losses, not just after, study findsMcKnight's Long-Term Care News; by Donna Shryer; 6/9/24A recent study suggests that healthcare professionals and policymakers should expand their focus on supporting the emotional well-being of individuals whose spouses have dementia, especially in the years leading up to their partners’ deaths. The clinical investigation, published in the Journal of the American Geriatrics Society, indicates that these caregivers experience heightened levels of psychological distress compared to those whose partners have normal cognitive function. ... After the partner’s death, the levels of loneliness and depression were similar across all groups, regardless of the deceased partner’s cognitive status. This suggests that the period before the loss is particularly challenging for those caring for a spouse with dementia. Furthermore, about two-thirds (64%) of these spouses reported lower life satisfaction compared to nearly three-quarters (74%) of those with cognitively healthy partners. However, the study found no significant difference in social isolation levels among the groups.

'I don't ever trust Epic to be correct': Nurses raise more AI concerns Becker's Health IT; by Giles Bruce; 6/14/24 Nurses continue to voice concerns about artificial intelligence and its integration into EHRs, saying the technology is ineffective and interferes with patient care. Nurses from health systems around the country spoke to National Nurses United, their largest labor union, for a June 5 story about issues with such programs as automated nurse handoffs, patient classification systems and sepsis alerts. Multiple nurses cited problems with EHR-based programs from Epic and Oracle Health that use algorithms to determine patient acuity and nurse staffing levels. "I don't ever trust Epic to be correct," Craig Cedotal, RN, a pediatric oncology nurse at Kaiser Permanente Oakland (Calif.) Medical Center, told the nurses' union. "It's never a reflection of what we need, but more a snapshot of what we've done." ... Hundreds of nurses protested AI at Kaiser Permanente San Francisco Medical Center in April.

AAHPM CMO Joe Rotella: Hospice does not exist to save money Hospice News; by Jim Parker; 6/17/24Dr. Joe Rotella, chief medical officer of the American Academy of Hospice and Palliative Medicine (AAHPM), calls on hospices to maintain their core principles amid a churning sea of regulatory and economic changes. Rotella began his medical career as a primary care physician in a small, rural town in central New Hampshire, where he stayed for 12 years [followed by serving Hospice & Palliative Care of Louisville, KY/Hosparus as Chief Medical director for 15 years]. ... Now, Rotella will soon retire from AAHPM. Hospice News sat down with Rotella to discuss the ways hospice and palliative care have changed during his tenure in the space, as well as the forces shaping the field’s future. ...

Alive welcomes experienced hospice leader as new CEO: Middle Tennessee's only nonprofit hospice provider poised to build on industry-leading reputationAlive Hospice; 6/13/24Alive, Middle Tennessee’s only nonprofit provider of hospice and palliative care and end-of-life services, today announced Kerry Hamilton as the organization’s new president and chief executive officer. He will begin his new role on June 24. A highly accomplished health care leader, Hamilton joins Alive with more than 20 years of direct hospice management experience, including a decade as CEO of nonprofit Hospice of Central Ohio. ... Hamilton’s hiring comes one year after news broke that Alive was considering a sale to a for-profit entity. The news led to a tremendous outpouring of support from the community for Alive to remain nonprofit. Ultimately, the Board of Directors made the decision that Alive would remain an independent nonprofit organization. The Board then began the search for a new CEO who shared its vision for the future.

Fashion for a Cause shatters another record, raises $240,000 for children’s programs: : Hospice of the Chesapeake The Baynet, Annapolis, MD; by Hospice of the Chesapeake; 6/13/24 Doing great never looked so good on June 7 as around 350 fun-loving people enjoyed perfect weather outside and perfect looks inside at the 14th annual Fashion for a Cause. Held at the Fluegel Alumni Center in Annapolis, the high-spirited crowd smashed its fundraising record, bringing in more than $240,000 for Chesapeake Kids, the Hospice of the Chesapeake program which supports children living with and affected by advanced illness and loss. Returning for his third year was emcee Bryan Nehman, cohost of C4 and Bryan Nehman weekday mornings on WBAL NewsRadio. Sharing the podium with Hospice of the Chesapeake President and CEO Becky Miller, they introduced Marie Burgess, who shared her family’s journey with the Chesapeake Kids program. Editor's Note: Congratulations Hospice of the Chesapeake on this outpouring of community support!

Why doctors aren’t participating in organ donation after cardiac death Physician's Weekly; by Frank D. Brodkey, MD, FCCM; 6/13/24Organ donation after cardiac death (DCD) differs from the more traditional organ donation after brain death (DBD) insofar that DCD donors are alive and donate organs after discontinuation of life support so that a natural death with cessation of heartbeat and circulation may occur, followed by extraction of organs. This may increase the availability of transplantable organs, leading to improvement in the lives of other humans.  According to the Health Resources and Services Administration, 5896 donations, representing 36% of all donations in 2023, were DCD, representing an increase of 40.7% over the preceding three years. There, however, are significant ethical and scientific issues in the performance of DCD with concepts of end-of-life care, personal autonomy, and concepts of dignity of life and death. ...

Minnesota family featured in new Amazon docuseries covering end-of-lifeCBS News WCCO (MN); by Mackenzie Lofgren, Derek James; 6/12/24A Blaine woman and her family will be featured in Amazon Prime's new six-episode docuseries, "Take Me Out Feet First." The docuseries follows individuals advocating for end-of-life options. The series was created by New York City native, Serene Meshel-Dillman, who was inspired to make the docuseries after she witnessed both of her parents end their lives in the comfort of their home. "Take Me Out Feet First" is a six-part docuseries made in partnership with the nonprofit advocacy group Compassion & Choices. Each episode will follow a different individual or family who has, advocated for, or is actively exploring end-of-life options. The docuseries is available to stream now on Amazon Prime.

Advocates rally in DC for the future of hospice: NHPCO and HAN amplify provider voices on Capitol Hill NHPCO; Press Release; 6/13/24 More than 100 hospice and palliative care advocates from across the country met with over 150 congressional offices this week to discuss key legislative and regulatory priorities for ensuring and expanding access to hospice and palliative care. The meetings were part of Hospice Action Week, hosted in Washington, DC by the National Hospice and Palliative Care Organization (NHPCO) and its advocacy affiliate, the Hospice Action Network (HAN). “The cornerstone of effective advocacy is storytelling. It’s about sharing why hospice holds personal significance and why serious illness and end-of-life care policy should resonate with our lawmakers,” said Logan Hoover, NHPCO’s VP of Policy & Government Relations. “From Hawaii to Rhode Island, advocates from 35 diverse states came to DC this year. The relationships they’re building with Members of Congress hold the potential to shape the future of the healthcare landscape.” 

CMS: Home healthcare spending estimated to grow by 7.1 percent from 2025 to 2026, surpassing other sectorsMcKnight's Home Care; by Adam Healy; 6/12/24National spending on home healthcare is projected to grow faster than any other health sector in the years ahead, according to newly published data from the Centers for Medicare & Medicaid Services’ Office of the Actuary [see Health Affairs: National Health Expenditure Projections, 2023-32: Payer Trends Diverge As Pandemic-Related Policies Fade]. Between 2025 and 2026, national spending on home health care is expected to increase by 7.1%, a data analysis published Wednesday in HealthAffairs revealed. Projected spending growth in home health care should outpace all other categories including hospital care services (4.9%), physician and clinical services (4.8%) and nursing homes care (4.8%), and it is expected to grow even faster during the following years. Between 2027 and 2032, the sector will see spending growth of 8.1%, compared to hospital spending (5.6%), physician and clinical services (5.5%) and nursing home care (6%). In 2022, home health spending increased by roughly 6%, CMS disclosed in a previous report.

Discharge for non-compliance?[Podcast] CHAPcast; 6/12/24Ever wondered why patients miss their medication schedules despite clear instructions? Our enlightening conversation with Dr. Kate Jones reveals the critical shift from simply labeling patients as "non-compliant" to understanding the complexities behind "patient adherence." Discover how patient-centered care and shared decision-making can transform healthcare outcomes and why addressing social determinants of health (SDOH) is paramount for effective and realistic care plans.