Literature Review

Streamlining financial processes in end-of-life care: The crucial role of revenue cycle management for hospices United Business Journal - UBJ; by Rahul Kumar; 7/16/24In the increasingly complex healthcare landscape, hospices face unique challenges in managing their financial processes. One crucial aspect that significantly impacts their efficiency and sustainability is Revenue Cycle Management (RCM) for hospices. This blog post aims to shed light on the essential role of RCM for hospices in streamlining financial operations, ensuring they can continue to provide compassionate and high-quality end-of-life care.

Targeted palliative care enhances outcomes in advanced cancer Physician's Weekly; 7/15/24 ... Excessive polypharmacy is common in patients with cancer, especially older adults. According to a 2023 study published in Cancer, up to 80% of older patients take five or more medications, and up to 40% take 10 or more. Patients who receive numerous medications as part of supportive care may be at increased risk for potentially inappropriate medications and drug-drug interactions, which could impact their QOL. The study authors emphasized the importance of meaningful screening and interventional tools to optimize the use of medications for palliative care in these patients. In a more recent study published in the Journal of Clinical Oncology, Giusti Raffaele, MD, and colleagues aimed to streamline pharmacotherapy by targeting the most impactful symptom.

Pain management in the wake of the opioid crisis Forbes; by Web Golinkin; 7/15/24 Pain is the single most frequent reason for patient visits in the United States. An estimated 20 percent of adults experience chronic pain, and nearly seven percent experience a level of chronic pain that limits their daily activities. However, most doctors and other healthcare professionals have very little education in pain management, according to Scott Fishman, MD, an internationally recognized expert in pain management, ... This lack of education was one of the main causes of the Opioid Crisis, Fishman says ... of the part of the crisis that was caused by the over-prescribing of opioids, many clinicians have become so wary of the medical-legal issues surrounding pain management that they have gone from an overly liberal approach to a restrictive one in which some prescribers are effectively abandoning patients who need to have their symptoms treated. Both extremes are frequently fueled by lack of knowledge and training, according to Fishman. ... The solution is to close the education gap ...

Fifth of UK hospices cutting services amid funding crisis, finds report The Guardian, UK; by Andrew Gregory; 7/16/24 One in five hospices in the UK are cutting services amid the worst funding crisis in two decades, a report has warned, with soaring numbers of patients being pushed back into the NHS. Research by Hospice UK found “small and wildly varying” state funding had failed to keep pace with growing demand and rising running costs. That means inpatient beds are being cut, staff made redundant and community services restricted, with fewer visits to dying patients in their own homes, according to the charity, which represents more than 200 hospices across the country.

Advanced practice providers have an important role in kidney supportive care Healio; by Christine Corbett, DNP, FNP-BC, CNN-NP, FNKF; 7/15/24For more than 2 decades, nephrologists and patients have recognized the key role nephrology advanced practice providers have played in the care of patients with chronic kidney disease. ... With its attention to the psychosocial and spiritual aspects of care in addition to the physical, it is expected that nephrology nurse practitioners would also play a major role in the palliative care for patients with kidney disease. ... As part of the kidney care team, APPs [advanced practice practitionsers] educate patients about kidney failure treatment options, including palliative dialysis and active medical management without dialysis. Also, nurse practitioners have been noted to play a significant role in the palliative care skills of goals-of-care conversations, advance care planning and Portable Orders for Life-Sustaining Treatment (POLST, or similar term depending on the state) completion.

Glitzy Scottsdale couple jailed in $900M fraud Gilbert Sun News; by Tom Scanlon; 7/14/24 ... According to a federal indictment, “Alexandra Gehrke and Jeffrey King were charged for targeting elderly Medicare patients, many of whom were terminally ill in hospice care, for medically unnecessary wound grafts.” Gehrke – known to friends and associates as “Lexie” – and King allegedly filed $900 million in fraudulent claims, pocketing “$330 million in illegal kickbacks as a result of their fraudulent scheme.” According to the indictment, they were responsible for “allograft” bandages being applied frivolously to hundreds of patients, many of them dying. According to Gehrke’s LinkedIn profile, “APEX Medical is a national medical device distribution company. 

Cherokee nation: Closing gap in health care disparities Native News Online; by Churck Hoskin, Jr.; 7/14/24 ... American Indians in Oklahoma die on average 17 years earlier than their non-Indigenous neighbors. While this finding is alarming, it comes as no surprise to the Cherokee Nation or to the nearly 40 other tribal nations in Oklahoma. ... Even as we continue our advocacy efforts, we cannot afford to wait for the federal government to fulfill its responsibilities. That's why the Cherokee Nation, which operates the largest Native American health care system in the country, is taking unprecedented steps to address this crisis head-on. ... [We] are confident our historic investments in health care and wellness are improving health outcomes for our Cherokee citizens. Construction continues on the Cherokee Nation’s new $400 million, 400,000-square-foot state-of-the-art hospital being built in the capital city of Tahlequah. The new hospital will include an ER, surgery, ICU, imaging, pharmacy and lab, neo-natal ICU, hospice, dietary and acute care, and many other services. 

Palliative care training initiative launches to improve quality among incarcerated populations Hospice News; by Holly Vossel; 7/12/24 The California Department of Corrections & Rehabilitation’s Medical Facility (CMF) has launched a new palliative spiritual care training program aimed at improving services for incarcerated individuals. The new two-week spiritual training program was recently provided to palliative care service workers and volunteers to assist CMF’s clinical and nursing staff caring for patients at the facility’s hospice, correctional treatment center and memory care units. A dozen trainees recently completed the program, with CMF planning to provide an annual refresher course to all of its palliative care service workers, according to California Correctional Health Care Services CEO Joseph Garland. 

Lewiston community honors shooting and hospice victims with butterfly release celebration CBS WGME TV13, Lewston, Maine; by Aysia Reed; 7/13/24 Hundreds of butterflies took flight in Lewiston on Saturday for the 15th annual Butterfly Release Celebration hosted by Andwell Health Partners.  Hundreds of names were read off Saturday at the Geiger Elementary School in Lewiston to honor those who have died in hospice. And this year the names of Lewiston mass shooting victims were honored too. The event is put on by Andwell Health Partners, a Maine healthcare nonprofit providing services for hospice patients and their families. Once names were read, one thousand monarch butterflies were released- a symbol of transformation and hope.Editor's Note: On October 25, 2023 in Lewiston, Maine, 18 individuals died and and 13 others were injured by a shooter at a bowling alley and restaurant.   

The Medicare Post-Acute Care and Hospice Provider Public Use File (PAC PUF)CMS press release; 7/10/24[This file] provides information on services provided to Medicare beneficiaries by home health agencies (HHAs), hospices, skilled nursing facilities (SNFs), inpatient rehabilitation facilities (IRFs), and long-term care hospitals (LTCHs).  It contains information on demographic and clinical characteristics of beneficiaries served, professional and paraprofessional service utilization, submitted charges, and payments at the provider, state, and national levels.  Additionally, the PAC PUF includes payment information at the case-mix grouping level for HHAs, SNFs, and IRFs.

Hospice CARES Act would update medical reviews, seek to reduce audits Hospice News; by Jim Parker; 7/12/24 The forthcoming Hospice Care Accountability, Reform and Enforcement (Hospice CARE) Act from U.S. Rep. Earl Blumenaur (D-Oregon), if enacted, would implement a number of changes to medical review processes. ... Though the bill language is still in development, it will likely contain proposed updates to payment mechanisms for high-acuity palliative services, changes to the per-diem payment process and actions to improve quality and combat fraud. The bill would also implement a temporary, national moratorium on the enrollment of new hospices into Medicare, to help stem the tide of fraudulent activities among recently established providers concentrated primarily in California, Arizona, Texas and Nevada. ... Among the anticipated provisions of the bill would be an item requiring the U.S. Centers for Medicare & Medicaid Services (CMS) to use documentation in a patient’s medical record as supporting material. The documentation would include the reasons that an attending physician certified a patient for hospice and establish a six-month terminal prognosis.

Hospice of North Idaho receives $30K donation Coeur d'Alene / Post Falls Press, St. Coeru D'Alene, Idaho; 7/13/24 Coldwell Banker Schneidmiller Realty recently donated $30,000 to Hospice of North Idaho to support the Schneidmiller House Inpatient Hospice Unit. The donation will help ensure the continued provision of world-class end-of-life care to the community, a press release said. "The gift of our Hospice House and our exemplary care for those we serve is actually a gift from all those in our community that support our mission as Coldwell Banker has today," said Eric Ladwig, executive director of Hospice of North Idaho. Robert Brickett, vice-president of Coldwell Banker Schneidmiller Realty, said they were honored to contribute to Hospice of North Idaho and support the exceptional care they provide. "Our company believes in giving back to the community that has supported us for so many years," he said.