Literature Review

What health system CEOs need to tackle conflict, change Becker's Hospital Review; by Laura Dyrda; 5/31/24  Health system CEOs are leaving behind ego-driven, top down leadership in favor of a trusting and a supportive culture to guide their organizations and transform healthcare delivery. Change is hard, but necessary, to grow. "One of my greatest realizations is the importance of fostering a culture where every individual genuinely feels valued and supported," K. Craig Kent, MD, CEO of Charlottesville, VA.-based UVA Health and executive vice president of health affairs at the University of Virginia told Becker's. ... Change is happening on many fronts. More care is exiting the hospital to be delivered at outpatient sites, in the home and through virtual connections. Patients are more actively participating in decision-making about their care, and digital technology makes it possible to personalize care more than ever before. ...

LeadingAge: CMS on right track with high-acuity hospice RFIHospice News; by Jim Parker; 5/31/24 The senior care advocacy group LeadingAge has praised the U.S. Centers for Medicare & Medicaid Services (CMS) inquiries into high-acuity palliative care, but expressed concern over reimbursement and staffing issues. The agency’s 2025 proposed hospice rule featured a series of requests for information (RFI) on issues like health equity, social determinants of health and future quality measures. The RFIs contain further questions about the utilization of higher-cost palliative treatments under the Medicare Hospice Benefit. The agency posed similar queries in its proposed rule for 2024. The new proposal seeks greater clarity on the financial risks and costs that providers say represent barriers to providing those services, such as palliative chemotherapy, radiation blood transfusions or dialysis, among others.

Palliative care significantly improves discussion and documentation of end-of-life care preferences among patients with AML and MDS Oncology Learning Network; transcribed interview featuring Areej El-Jawahri, MD; 6/1/24 Areej El-Jawahri, MD, Massachusetts General Hospital, Boston, Massachusetts, discusses results from a clinical trial comparing a collaborative palliative and oncology care model vs usual care for adult patients with acute myeloid leukemia (AML) and high-risk myelodysplastic syndrome (MDS). The study showed that palliative care significantly improved the rates of discussion and documentation of end-of-life (EOL) care preferences, reduced hospitalization at the EOL, and improved the quality of life in patients. 

Hospice Certifying Physician edit in effectAAPC - American Academy of Professional Coders; by Rebecca Johnson; 6/3/24 The Centers for Medicare & Medicaid Services (CMS) and its Home Health and Hospice (HHH) Medicare Administrative Contractors (MACs) are all systems go for the new — and potentially troublesome — claims system edit. The edit went into effect June 3. ... In the 2024 Hospice Payment Rate Update final rule, CMS adopted a requirement that two categories of physicians must be enrolled in or validly opted out of Medicare for hospice services to be paid: the hospice medical director or the physician member of the hospice interdisciplinary group; and the attending physician that certifies the patient for hospice. CMS did at least grant hospices’ requests for an implementation delay at that time, moving the deadline from the proposed Oct. 1, 2023, to May 1, 2024. Then, on the eve of that start date, CMS bumped the edit for one more month. ...

Community Hospice & Palliative Care setting sights on Florida, Georgia expansionHospice News; by Holly Vossel; 6/3/24Florida-based Community Hospice & Palliative Care recently opened a new location in its home state that will serve as an office for interdisciplinary staff and a community center. The new center is a key part of the hospice and palliative care provider’s overall strategic growth plans to improve access among underserved populations, according to Community CEO Phillip Ward. ... One aim of launching the center is to improve care collaboration and access among African Americans in the community, according to Ward.

Empathetic AI: How Genai virtual agents will be leveraged Informa; by Josh Streets; 6/3/24 Imagine you're shopping online or in a store and have a question about a product. But you don’t want to find a store employee or call into their contact center to speak with a salesperson while you wait for answers. With a simple snapshot of a QR/UPC code on the product or a tap on your mobile device within an application, you're instantly connected to a virtual agent via video chat. This AI assistant not only understands your questions but can also pick up on your facial expressions and body language via your video discussion, to respond with empathy and some level of emotional intelligence. "I can see you're a bit frustrated," the virtual agent says with a warm, reassuring tone. "Let me walk you through the product details and address any concerns you might have."Editor's Note: This AI solution might be great for shopping, but is it ethical for hospice care, especially when the person calling might be elderly and assumes they are talking with a person? How would you feel, especially if you're calling when your loved is actively dying, or has just died moments before? 

There is a crack in everything, that’s how the light gets in. – Leonard Cohen

Telehealth delivers early palliative care as effectively as in-person careAJMC, American Society of Clinical Oncology; by Laura Joszt, MA; 6/2/24 Early palliative care can be delivered via telehealth with equivalent quality-of-life effects as palliative care delivered in person to patients with advanced non–small cell lung cancer (NSCLC), according to late-breaking results presented during [a] plenary session at the 2024 American Society of Clinical Oncology (ASCO) annual meeting. Whether the palliative care was delivered in person or via telehealth, the most common topics discussed during the visit were similar and included building and establishing rapport to create a relationship with the patient and their family, identifying symptoms and grading symptom management, and coping with serious illness, explained Joseph Greer, PhD, codirector of the Cancer Outcomes Research & Education Program at Massachusetts General Hospital Cancer Center and associate professor of psychology in the Department of Psychiatry at Harvard Medical School ...

UnitedHealth Group continues to leverage home-based care to drive value-based strategy Home Health Care News; by Robert Holly; 5/30/24 Value-based care has long been a core focus for UnitedHealth Group and its Optum arm. Recently, however, the health care giant has started to view value-based care as a sustainable business model that it can lean into to drive growth across its operations. ... “Although it’s a topic that has been talked about for probably 30 years as a theme, I would say, really, only within UnitedHealth Group and Optum are you seeing value-based care now on a scale and presence [that] allows it to operate truly as a business model,” UnitedHealth Group CEO Andrew Witty said Wednesday, speaking at an investor conference.

Reminders for the new Hospice Certifying Physician Claim Edit: Effective June 3, 2024

Pacs Group CEO calls for caution when dealing with private equityModern Healthcare; by Diane Eastabrook; 5/30/24Do you think private equity is becoming a problem for nursing homes? [Pacs Group Chair and CEO Jason Murray replies] I’m not saying that all private equity is inherently bad, but I do think that if providers are not careful about how the capital is aligned with their mission as a company, then you can get into some dangerous situations. As the company tries to perform, they might not be at the level where the capital partner would like them to be, so the business plan changes. Whenever that business plan changes from patient care to a return on capital, it’s a losing scenario.

Dr. Marc Boom confronts the new dynamics of CEO burnoutBecker's Hospital Review; by Kelly Gooch; 5/23/24While the topic of burnout among hospital CEOs is not new, there are new dynamics in play to consider as part of the discussion. Those in the role today encounter increased pressures ranging from financial to operational. "There are new pressures that have emerged in the healthcare delivery world - everything from reimbursement cuts and escalating drug and supply costs, and labor expenses - that have created a lot of financial headwinds for organizations," said Scott Sette, a partner with Chicago-based executive search firm Heidrick & Struggles. "Plus, regulatory changes have forced CEOs to spend more resources on compliance, cybersecurity, EMR administration." Additionally, "there have just been so many workforce challenges. ... Then you have the impact of the remote and hybrid workforce and the impact of that on organizational culture. Plus, you've got many social issues going on. Clearly, [diversity, equity and inclusion] continues to be top of mind, but also you've got political unrest. You have mass shootings. You have gender-affirming care and other social issues that organizations have to address. And all of these topics [have] created even more pressures for hospitals and health systems to deal with, in addition to delivering high-quality care and delivering customer-centric experiences. There is a lot for CEOs to deal with on a daily basis." Marc Boom, MD, has served as president and CEO of Houston Methodist, an eight-hospital system with more than 32,000 employees, since 2012. He acknowledged these pressures in a recent interview with Becker's. He also discussed the prevalence of burnout and shared advice for how leaders can reduce the potential for it.