Literature Review

Large systems outsource home care to focus on 'core business' Becker's Hospital CFO Report; by Alan Condon; 10/25/24 A growing number of health systems are outsourcing home health and hospice operations to third-party specialists with broader geographic reach to reduce cost and administrative burdens and focus on core services. The regulatory environment for home health and hospice is complex, with stringent requirements for reimbursement, reporting and patient care standards. Partnering with an outsourced provider also helps systems mitigate the risks associated with non-compliance and operational issues. Here are four health systems that have outsourced or plan to outsource home health and hospicare care:

UnitedHealth Group, Amedisys to meet with Justice Department to push for acquisition’s closure Hospice News; by Jim Parker; 10/26/24 Executives from UnitedHealth Group and Amedisys reportedly will meet with U.S. Justice Department officials in an effort to seal their pending deal. Amedisys has indicated that it expects the deal to close in Q4. However, the Justice Department (DOJ) has been making inquiries into the transaction and reportedly has been considering a lawsuit to block it, due to potential antitrust concerns. To date, neither Amedisys nor UnitedHealth Group have been accused of any wrongdoing. Bloomberg first reported on the DOJ meeting, which might begin on Monday, according to sources “familiar with the matter.” The meeting will include Jonathan Kanter, assistant attorney general for the DOJ’s Antitrust Division, Bloomberg reported.

Diagnosed with disease he studied, Stanford doctor puts his personal story at center of new class. NBC Bay Area; 10/24/24 Stanford Medicine physician Dr. Bryant Lin is the perfect professor to teach the course “From Diagnosis to Dialogue: A Doctor's Real-Time Battle with Cancer” at Stanford. And that’s not necessarily a good thing. The class focuses on the cancer journey of a non-smoking patient diagnosed with lung cancer. Dr. Lin is that patient. “I want to take something that is obviously very negative to me personally and get some benefit out of it for at least for other people,” Dr. Lin said. 20 years ago, Dr. Lin chose a career in medicine for a simple reason. “I wanted that personal connection and that satisfaction from helping people on a day-to-day basis,” Dr, Lin said. This same motivation led Dr. Lin to co-found Stanford’s Center for Asian Health Research and Education in 2018, with a particular focus on lung cancer in non-smokers. This is why Dr. Lin was (and in a way was not) surprised when earlier this year he found himself part of the 20% of lung cancer patients who have never smoked. ...  [Click on the title's link to continue reading this inspirational story.]

Hospice executives laser-focused on regulation, see change on horizon Hospice News; by Holly Vossel; 10/24/24 ... Hospice News spoke with c-suite executives who have recently stepped into their roles to learn more about what led them to the space and their top priorities. Regulatory challenges are among hospice leaders’ most significant concerns. They also envision opportunities to reform the Medicare Hospice Benefit and diversify their scope of services.

Customizing a palliative program to patient, payer priorities Hospice News; by Jim Parker; 10/23/24 While some palliative care programs mirror the hospice model, more operators are working to tailor their services to patients’ specific needs, with varying intensity. This is increasingly important as payment shifts towards value-based payment models in which demonstrating cost savings is crucial to success. Providers need to demonstrate strong performance on quality scores as well as a track record of effectively preventing avoidable hospitalizations, readmissions and emergency department visits. This is particularly the case when negotiating contracts with Medicare Advantage plans, Accountable Care Organizations (ACOs) and other value-based payment arrangements, Sue Lynn Schramm, a partner of the hospice and palliative care consulting company Confidis, LLC, said in a presentation at the National Hospice and Palliative Care Organization Annual Leadership Conference. [Click on the title's link to continue reading.]

Telehealth vs in-person early palliative care for patients with advanced lung cancer-A multisite randomized clinical trialJAMA; Joseph A. Greer, PhD; Jennifer S. Temel, MD; Areej El-Jawahri, MD; Simone Rinaldi, ANP-BC; Mihir Kamdar, MD; Elyse R. Park, PhD, MPH; Nora K. Horick, MS; Kedie Pintro, MS; Dustin J. Rabideau, PhD; Lee Schwamm, MD; Josephine Feliciano, MD; Isaac Chua, MD, MPH; Konstantinos Leventakos, MD, PhD; Stacy M. Fischer, MD; Toby C. Campbell, MD; Michael W. Rabow, MD; Finly Zachariah, MD; Laura C. Hanson, MD; Sara F. Martin, MD; Maria Silveira, MD; Laura Shoemaker, DO; Marie Bakitas, DNSc; Jessica Bauman, MD; Lori Spoozak, MD; Carl Grey, MD; Leslie Blackhall, MD; Kimberly Curseen, MD; Sean O’Mahony, MB, BCh, BAO; Melanie M. Smith, MD; Ramona Rhodes, MD; Amelia Cullinan, MD; Vicki Jackson, MD; for the REACH PC; 9/24The delivery of early palliative care virtually vs in person demonstrated equivalent effects on quality of life in patients with advanced NSCLC [non-small cell lung cancer], underscoring the considerable potential for improving access to this evidence-based care model through telehealth delivery.

Annual wellness visits and early dementia diagnosis among Medicare beneficiariesJAMA Network Open; Huey-Ming Tzeng, PhD; Mukaila A. Raji, MD, MS; Yong Shan, PhD; Peter Cram, MD, MBA; Yong-Fang Kuo, PhD; 10/24Optimal dementia care depends on early recognition of cognitive impairment and timely diagnosis of Alzheimer disease and related dementias (ADRD). Optimal dementia care should reflect what matters most to patients and adhere to evidence-informed ADRD stage-specific health care. These findings indicate that AWV [annual wellness visit] recipients had a timelier first MCI [mild cognitive impairment] diagnosis than those who did not receive an AWV, but first ADRD diagnosis differed little. This study suggests that the Medicare AWV health policy may increase MCI identification, prompting more specialized care.

Martis Capital rumored to purchase Three Oaks Hospice’s in $150m deal Hospice News; by Holly Vossel; 10/18/24 The private equity firm Martis Capital may soon acquire Dallas-based Three Oaks Hospice for a price tag ranging from $150 million to $160 million. Rumors of the potential sale appeared today in an Axios report, in which unnamed sources reportedly confirmed the deal. The Nashville-based investment and management company Petra Capital currently owns Three Oaks Hospice, which reportedly generates between $10 and $13 million in EBITDA, Axios indicated. Rumors that the hospice was considering a potential sale were first reported last month by the website Ion Analytics. The private-equity backed company provides hospice, palliative care and bereavement services across 28 locations in seven states. 

Home health care aide charged with manslaughter in death of elderly central Florida man West Orlando News, Orlando, FL; by Staff; 10/20/24[This article updates the story we posted on 10/1/24, Polk County home health aide accused of sleeping on the job arrested in man’s death: ‘He was old anyway.']... According to the affidavit, Taylor, who was employed by Assisting Hands Home Health Care as a health aide, worked the evening hours at the man’s home in Winter Haven. ...  He was also receiving services from Good Shepherd Hospice beginning on August 14, 2024. ... During an autopsy, it was discovered the patient had an implanted pacemaker. The device manufacturer was later able to conduct a download and provide cardiac data stored on the victim’s implanted pacemaker which confirmed that the victim was still alive at 1:00am when the victim was initially found by Taylor lying on the floor. According to the Medical Examiner, had Taylor called 9-1-1 when she first found the victim, as required by her own company’s policy, the victim would not have died. The Medical Examiner ruled the victim’s cause of death positional asphyxia with a contributory cause of pre-existing health issues. 

Nonprofit endeavors to facilitate food justice Towne Post Network; by Julie Yate; 10/17/24 Bringing Justice Home [in Louisville, KY] is a nonprofit organization committed to alleviating hunger caused by food insecurity for those facing disabilities and chronic or serious illnesses. Now in its fourth year, the completely volunteer-run initiative seeks to facilitate food justice by delivering groceries and household supplies to health-compromised families and individuals who fall below the poverty line. Equally important is the relationship building that occurs as resources are shared and volunteers open their hearts to bringing justice closer to home. ... “Bringing Justice Home is a new kind of neighborhood that goes beyond zip codes, race, disabilities, health labels or status,” says Constance Merritt, who co-founded the organization along with her wife, Maria Accardi. Merritt is a published writer and a licensed social worker with a master’s degree from the University of Louisville. She has worked with older adults in low-income senior housing, patients and families in hospital palliative care, and individuals receiving HIV and AIDS services. 

Sunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!

Perspectives on artificial intelligence–generated responses to patient messagesJAMA Network Open; Jiyeong Kim, PhD, MPH; Michael L. Chen, BA; Shawheen J. Rezaei, MPhil; April S. Liang, MD; Susan M. Seav, MD; Sonia Onyeka, MD; Julie J. Lee, MD, MPH; Shivam C. Vedak, MD, MBA; David Mui, MD, MBA; Rayhan A. Lal, MD; Michael A. Pfeffer, MD; Christopher Sharp, MD; Natalie M. Pageler, MD, MEd; Steven M. Asch, MD, MPH; Eleni Linos, MD, DrPH; 10/24Generative artificial intelligence (AI) has the potential to assist clinicians in responding to patients’ messages. Satisfaction was consistently higher with AI-generated responses than with clinicians overall and by specialty. However, satisfaction was not necessarily concordant with the clinician-determined information quality and empathy. For example, satisfaction was highest with AI responses to cardiology questions while information quality and empathy were highest in endocrinology questions. Interestingly, clinicians’ response length was associated with satisfaction while AI’s response length was not. The findings suggest that the extreme brevity of responses could be a factor that lowers satisfaction in patient-clinician communication in EHR.

Virtual reality videos for symptom management in hospice and palliative careMayo Clinic Proceedings - Digital Health; by James R Deming, Kassie J Dunbar, Joshua F Lueck, Yoonsin Oh; 8/24Nature scenes significantly improved total symptom scores, as well as scores for drowsiness, tiredness, depression, anxiety, well-being, and dyspnea. The improved scores were not sustained 2 days later. Overall, bucket-list videos did not significantly improve symptoms. Neither previous experience with an activity nor a strong connection correlated with significant improvement; however, when patients rated video quality as outstanding, scores improved. Patients with lower functional status tended to have more symptoms beforehand and improve the most.