Literature Review
New York State Department of Health Launches Center for Hospice and Palliative Care
08/21/24 at 03:00 AMNew York State Department of Health Launches Center for Hospice and Palliative Care New York State Department of Health; Press Release; 8/19/24 The New York State Department of Health today announced the new Center for Hospice and Palliative Care, which will be under the Department's Office for Aging and Long Term Care (OALTC). The new Center, established under the leadership of Governor Kathy Hochul, will be led by Kara Travis, a health care executive who most recently served as Chief Executive Officer of Mountain Valley Hospice and Palliative Care in Gloversville, New York. "This new center will help us remove barriers that impact access to the profound comfort, support and dignity that palliative and hospice services can provide for individuals and families facing the end of life," State Health Commissioner Dr. James McDonald said. "Launching the Center for Hospice and Palliative Care was a top priority for this Department and highlights Governor Hochul's ongoing commitment to eliminating healthcare disparities for all New Yorkers."
Today's Encouragement: The difference between ordinary and extraordinary ...
08/21/24 at 03:00 AMThe difference between ordinary and extraordinary is that little extra. ~ Jimmy Johnson
Virtual reality tech takes hospice patients to faraway places
08/21/24 at 03:00 AMVirtual reality tech takes hospice patients to faraway places Yuma Sun; by Alex Ebrahimi; 8/18/24 Hospice patients take trips to those faraway places they never got to visit or simply see the faces of family again no matter where in the world they are. These "trips" are made possible with the use of free virtual reality headsets offered by Southwestern Palliative Care and Hospice. The first patient to wear the VR headset had worked all his life out in San Diego as a crane operator. The paychecks didn't go beyond the roof over his family's head. Now he's able to see some of the places he never got to see in real life.Editor's Note: To read more examples, click on the title's link.
Nationwide home healthcare and hospice provider to pay $3.85M to resolve False Claims Act allegations
08/21/24 at 03:00 AMNationwide home healthcare and hospice provider to pay $3.85M to resolve False Claims Act allegationsDepartment of Justice press release; 8/20/24Intrepid U.S.A. Inc., headquartered in Dallas, and various wholly-owned subsidiaries (Intrepid) have agreed to pay $3,850,000 to resolve allegations that Intrepid violated the False Claims Act in connection with two lines of its business: first, that Intrepid knowingly submitted claims to Medicare for home healthcare services for patients who did not qualify for the Medicare home healthcare benefit or where services otherwise did not qualify for Medicare reimbursement; and second, that Intrepid knowingly submitted claims to Medicare for patients who did not qualify for the hospice benefit. The settlement is based on Intrepid’s ability to pay.
Hospice CARE Act would create reimbursement for high-acuity hospice services
08/21/24 at 03:00 AMHospice CARE Act would create reimbursement for high-acuity hospice services Hospice News; by Holly Vossel; 8/19/24 If enacted, the Hospice Care Accountability, Reform and Enforcement (Hospice CARE) Act could open up reimbursement pathways for high-acuity palliative services during a time when demand and costs are rising. Developed by U.S. Rep. Earl Blumenaur (D-Oregon) and announced in June at the Hospice News Elevate conference, the bill proposed massive reimbursement and regulatory changes to the Medicare Hospice Benefit. Currently in a discussion draft phase, the bill includes ways for hospice providers to have clearer definitions and improved payment for more intensive forms of palliation, such as radiation therapy, blood transfusions or dialysis, among others.
Nationwide home healthcare and hospice provider to pay $3.85M to resolve False Claims Act allegations
08/21/24 at 03:00 AMNationwide home healthcare and hospice provider to pay $3.85M to resolve False Claims Act allegations U.S. Department of Justice Office of Public Affairs; Press Release; 8/20/24 Intrepid U.S.A. Inc., headquartered in Dallas, and various wholly-owned subsidiaries (Intrepid) have agreed to pay $3,850,000 to resolve allegations that Intrepid violated the False Claims Act in connection with two lines of its business: first, that Intrepid knowingly submitted claims to Medicare for home healthcare services for patients who did not qualify for the Medicare home healthcare benefit or where services otherwise did not qualify for Medicare reimbursement; and second, that Intrepid knowingly submitted claims to Medicare for patients who did not qualify for the hospice benefit. The settlement is based on Intrepid’s ability to pay.
The dangers of healthcare generative AI 'drift'
08/21/24 at 03:00 AMThe dangers of healthcare generative AI 'drift' Becker's Health IT; by Giles Bruce; 8/15/24 IT leaders are embracing generative AI in healthcare but also expressing concerns that the technology can "drift." The performance of GPT-4, the large language model that powers ChatGPT, in answering healthcare questions can change over time, a phenomenon known as "drift," according to a study by researchers at Somerville, Mass.-based Mass General Brigham. Their work was published Aug. 8 in NEJM AI. "Generative AI performed relatively well, but more improvement is needed for most use cases," said corresponding author Sandy Aronson, executive director of IT and AI solutions at Mass General Brigham Personalized Medicine, in an Aug. 13 statement. "However, as we ran our tests repeatedly, we observed a phenomenon we deemed important: running the same test dataset repeatedly produced different results." ... The variability of the results could differ across days, so the authors say the AI's performance needs to be continuously monitored.
Integration of palliative pharmacists to elevate oncologic care
08/21/24 at 03:00 AMIntegration of palliative pharmacists to elevate oncologic care Pharmacy Times; by Alexis Beachy, PharmD and Jessica Geiger, PharmD, MS, BCPS; 8/20/24... Conclusion: This case demonstrates several aspects of care palliative pharmacists can assist with, though it is certainly not all-encompassing. All things considered, pharmacists are an essential asset of the palliative team. Their experience further enriches the interdisciplinary team and grants all patients and families many benefits. Specifically, patients receiving oncologic care benefit from collaboration with a palliative care pharmacist. In addition to offering a more individualized and holistic approach to care, palliative pharmacists can also provide patients with quicker and improved symptom management, which often improves quality of life and may also increase survival rates.Editor's Note: This article provides excellent history, definitions, and descriptions of the pharmacist's significant role in providing expert palliative and hospice care.
John Oliver on US for-profit hospice care: ‘too important to just hope the free market fixes it'
08/21/24 at 02:00 AMJohn Oliver on US for-profit hospice care: ‘too important to just hope the free market fixes it' The Guardian; by Adrian Horton; 8/19/24 On the latest Last Week Tonight, John Oliver delved into the many issues with hospice care in the US. Doing so is “an almost offensive parody of this show”, he acknowledged. “If somebody else did that, it would genuinely be hurtful. But I promise this is worth talking about.” There are “lots of dedicated people work with hospices, providing huge relief for dying patients and their families, particularly those who want to remain at home”, such as the 1.8 million Americans who received end-of-life care at home last year. But like anything, hospice is subject to fraud, mismanagement and abuse. One government report estimated that hospice’s inappropriate billing costs Medicare hundreds of millions per year. ... “Hospice care, when done well, is hugely beneficial to those that are dying and their families. It is too important to just hope the free market fixes it,” Oliver concluded. “This industry badly needs reform. That’s clear.” [Click on links below for hospice responses to this "Hospice" episode of Last Week Tonight.]
Hospice physician’s convictions and $15 million in restitution affirmed for ‘pervasive’ fraud
08/21/24 at 02:00 AMHospice physician’s convictions and $15 million in restitution affirmed for ‘pervasive’ fraud CCH Incorporated; by Justin Marcus Smith, J.D.; 8/15/24 The Fifth Circuit found it circumstantially telling that the jurors saw multiple hospice patients testifying at trial nearly a decade after the convicted physician had recommended them for end of life care. In an unpublished opinion, the United States Court of Appeals for the Fifth Circuit affirmed a physician’s conviction for conspiracy to commit health care fraud and for seven individual counts of healthcare fraud in connection with hospice care service recommendations. Applying de novo review, the court affirmed the convictions on the basis that the government presented enough circumstantial evidence, without direct evidence of intent, for a reasonable jury to have found guilt. With respect to sentencing, the circumstances surrounding 7,000 hospice claims formed a basis for fraud so pervasive that the government did not need to “sift” through each of the claims.
Honest conversations and cherishing the day: Leadership advice from oncology leaders
08/20/24 at 03:30 AMHonest conversations and cherishing the day: Leadership advice from oncology leaders Becker's Hospital Review; by Elizabeth Gregerson; 8/16/24 Leaders from two of the top five cancer centers, as ranked by U.S. News & World Report, shared with Becker's the best leadership advice they have received. ...
Wisconsin DHS to create an HCBS minimum fee schedule
08/20/24 at 03:30 AMWisconsin DHS to create an HCBS minimum fee schedule Open Minds, Gettysburg, PA; 8/15/24 The Wisconsin Department of Health Services (DHS) is developing a minimum fee schedule for a subset of Medicaid home- and community-based services (HCBS) for which no specific rates exist in fee-for-service Medicaid. The minimum fee schedule will apply to adult family homes, community-based residential facilities, residential apartment complexes, supportive home care (SHC) agencies, and self-directed SHC. The affected programs include Family Care, Family Care Partnership, and Program of All-Inclusive Care for the Elderly (PACE), which together serve nearly 57,000 older adults and adults with disabilities.
34 hospitals, health systems raising workers' pay
08/20/24 at 03:00 AM34 hospitals, health systems raising workers' pay Becker's Hospital Review; by Kelly Gooch; 8/15/24 The following hospitals and health systems have announced or shared plans for raising workers' pay this year. This is not an exhaustive list. This webpage was last updated on Aug. 15.
Humana will pay $90 million in Medicare drug fraud settlement
08/20/24 at 03:00 AMHumana will pay $90 million in Medicare drug fraud settlement Bloomberg Law; by Daniel Seiden; 8/16/24 Humana Inc. agreed to pay $90 million to the federal government to settle a whistleblower’s False Claims Act suit alleging that the company submitted fraudulent bids for Medicare Part D prescription drug contracts. Whistleblower Steven Scott alleged that, since 2011, Humana began offering its Medicare Part D prescription drug plan, known as the basic Walmart Plan, and “knowingly provided benefits under that plan that have been significantly less valuable than Humana promised in its bids,” according to Scott’s suit filed in 2016 in the US District Court for the Central District of California. ... This suit was among several in 2016, including suits against Humana, United Health, Cigna Corp., and Optum RX Inc., accusing health insurers of secretly overcharging for prescription drugs.
Busted: The top fraud schemes of Q2 2024
08/20/24 at 03:00 AMBusted: The top fraud schemes of Q2 2024 Cotiviti; by Erin Rutzler; 8/16/24 As we move through 2024, fraud, waste, and abuse (FWA) continue to be significant issues within healthcare. ... Here’s a rundown of notable FWA cases from April to June 2024.
Today's Encouragement: Many of life's failures ...
08/20/24 at 03:00 AMMany of life's failures are experienced by people who did not realize how close they were to success when they gave up. ~ Thomas Edison
4 health systems shrinking their hospital portfolios
08/20/24 at 03:00 AM4 health systems shrinking their hospital portfolios Becker's Hospital Review; by Alan Condon; 8/14/24 Merger and acquisition activity is picking up steam this year after a decline in deal volume during the pandemic, with some large health systems reorganizing their portfolios and offloading hospitals in various markets. Four health systems that have sold or plan to sell multiple hospitals this year:
Hospice’s post-VBID value-based outlook
08/20/24 at 03:00 AMHospice’s post-VBID value-based outlook Hospice News; by Holly Vossel; 8/15/24 The post-Medicare Advantage hospice carve-in landscape could include wider value-based reimbursement avenues in the hospice space, leading providers to pivot into MA payer relationships. The forthcoming end of the hospice component of the value-based insurance design (VBID) demonstrative takes effect Dec. 31. Launched in 2021, the carve-in was designed to test coverage of hospice care through Medicare Advantage, as well as coverage of palliative and transitional care. Hospices will need a strong value-based payment negotiation strategy to prepare for the unknowns that lie ahead, according to Melinda Gaboury, co-owner and CEO of Healthcare Provider Solutions Inc., a hospice and home care consulting company.
YoloCares: Overregulated California skips key regulations
08/20/24 at 03:00 AMYoloCares: Overregulated California skips key regulations Our Community Now (OCN); by Craig Dresang, Special to The Enterprise; 8/17/24 California is the most heavily regulated state in the country. According to the Mercatus Center at George Mason University, the Golden State has 420,434 regulatory restrictions which is more than double the national average. ... So, it seems ironic that certain critically important sectors in California that impact the well-being, health and quality of life for millions of seniors are grossly unchecked and mis-regulated. My husband, who has owned and operated salons for nearly 30 years, pointed out that California’s Board of Barbering and Cosmetology (BBC) appears to have more rigorous rules and regulations for nail technicians than it does for board-and-care (B&C) owners or privately owned hospice companies. ... [Click on the title's link to continue reading.]
Bereaved parent preferences on quality end-of-life care for children with cancer in the South
08/20/24 at 03:00 AMBereaved parent preferences on quality end-of-life care for children with cancer in the South Cancer - American Cancer Society; by Isaac Martinez BA, Erin Currie PhD, RN, Elizabeth S. Davis MS, Rohail Kumar MD, Valerie Lawhon MS, ALC, NCC, Jennifer M. Snaman MD, Raba B. Tefera BA, Smita Bhatia MD, MPH, Abby R. Rosenberg MD, MS, MA, Emily E. Johnston MD, MS; 8/18/24 The authors sought to understand bereaved family preferences for end-of-life (EOL) care, particularly among Black families and those in the South. ... Family decision-making involved maintaining hope, not causing harm, doing what was best for their child and themselves, and religious beliefs. There was no clear preference for home versus hospital death (3.0 [1.8–4.0]). Instead, parents considered their child’s desires and/or medical needs, siblings, and prior experiences with death. To have a comfortable death, parents highlighted the need for comprehensive education about their child’s EOL, a caring and comfortable environment, and 24/7 access to their care team. Families expressed a dual preference for comfort care ... and chemotherapy ... at EOL.
Why Optum thrives where other companies failed
08/20/24 at 03:00 AMWhy Optum thrives where other companies failed Becker's ASC Review; by Patsy Newitt; 8/16/24 UnitedHealth Group's Optum, parent company of Deerfield, Ill.-based ASC chain SCA Health, has seen massive growth in the last few years as other big healthcare networks face obstacles in reaching large-scale profitability. ... A key to Optum's success is its affiliation with a large insurance business. The Journal pointed to the "several financial incentives for an insurer to own a health provider, including that it pays itself." ... And Optum keeps growing. The company spent $31 billion on acquisitions in the last two years, The Oregonian reported May 13. ... UnitedHealth Group is facing scrutiny regarding the Change Healthcare ransomware attack in February. The attack delayed payment and claims processing for healthcare providers around the country, as UnitedHealth subsidiary Change Healthcare handles an estimated one in three healthcare transactions.
A friend until the end: The impact of hospice volunteers
08/20/24 at 03:00 AMA friend until the end: The impact of hospice volunteers Parkview Health, Fort Wayne, IN; 8/16/24 The presence of a hospice volunteer offers a unique form of support that complements the effots of a care team consisting of physicians, nurses, social workers and chaplains. While these specialists focus on a patient's physical, logistical and spiritual needs, volunteers contribute the element companionship during an emotionally difficult time. Jane Sandor, retired schoolteacher and principal, and Sally Stuckway, former executive director of a medical practice in Lafayette, IN, share how their personal experiences with hospice care shaped their desire to give back.
Medical marijuana study details Arkansans’ use of the drug, raises questions from lawmakers
08/20/24 at 03:00 AMMedical marijuana study details Arkansans’ use of the drug, raises questions from lawmakers Arkansas Times; by Tess Vrbin for the Arkansas Advocate; 8/15/24 ... The study, conducted by the Arkansas Center for Health Improvement, is the first ever population-based study of medical marijuana funded by a federal health agency, the National Institutes of Health. ... The state currently has more than 105,000 cardholders, an increase of roughly 29,000 in three years, according to ACHI’s study. ... Lawmakers on the Joint Public Health, Welfare and Labor Committee ... expressed concerns about some of the information in the study, such as the fact that one-third of the certifications for medical marijuana cards in 2021 came from just seven doctors, with little evidence of a physician-patient relationship in many cases.Thirty-eight states and the District of Columbia have legalized marijuana to some extent, and Arkansas is one of 14 states in which the drug is legal only for medicinal purposes.
HCA pushed out providers, downgraded care after acquiring Mission Health: report
08/20/24 at 03:00 AMHCA pushed out providers, downgraded care after acquiring Mission Health: report Healthcare Dive; by Susanna Vogel; 8/16/24 Dive Brief:
Destitute and dying: Interventions and models of palliative and end of life care for homeless adults – a systematic review
08/20/24 at 02:30 AMDestitute and dying: Interventions and models of palliative and end of life care for homeless adults – a systematic review BMJ Supportive & Palliative Care; United Kingdom; by Megan Rose Coverdale and Fliss Murtagh; 8/24 We identified key components of care to optimise the support for homeless adults needing palliative and end of life care: advocacy; multidisciplinary working; professional education; and care in the community. Future research must include the perspectives of those who are homeless.