Literature Review

MedPAC: March 2026 Report to CongressMedPAC Reports; 3/12/26Medicare Benefit: National health care spending grew rapidly in 2023 and 2024, by 7 percent in each of these years. By 2024, national health care spending totaled $5.3 trillion. Health care spending has made up an increasing share of the country’s gross domestic product (GDP) over time, rising from about 13 percent of GDP in 2000 to 18 percent in 2024. Medicare spending grew more rapidly than national health care spending in 2023 and 2024 (by 9 percent and 8 percent, respectively), in part due to changes in Part D financing that shifted more of the cost of prescription drug coverage from beneficiaries to the federal government. By 2024, Medicare spending totaled $1.1 trillion—equivalent to 21 percent of national health care spending and 3.8 percent of GDP. (Please see the full report here for additional detail.)Hospice Chapter:

Call for applications: Investigator in Residence ProgramASCENT press release; 3/2/26The Advancing the Science of Palliative Care Research Across the Lifespan (ASCENT) Consortium invites applications for its 2026 Investigator in Residence Program. The goal of this program is to increase the number of palliative care investigators, expand the range of institutions where palliative care research is performed, and develop scientific and leadership capabilities leading to future successful grant proposals, both through ASCENT and extramurally. Applications due Thursday, March 26 at 5:00 pm PT.

MedPAC: March 2026 Report to CongressMedPAC Reports; 3/12/26Medicare Benefit: National health care spending grew rapidly in 2023 and 2024, by 7 percent in each of these years. By 2024, national health care spending totaled $5.3 trillion. Health care spending has made up an increasing share of the country’s gross domestic product (GDP) over time, rising from about 13 percent of GDP in 2000 to 18 percent in 2024. Medicare spending grew more rapidly than national health care spending in 2023 and 2024 (by 9 percent and 8 percent, respectively), in part due to changes in Part D financing that shifted more of the cost of prescription drug coverage from beneficiaries to the federal government. By 2024, Medicare spending totaled $1.1 trillion—equivalent to 21 percent of national health care spending and 3.8 percent of GDP. (Please see the full report here for additional detail.)

New partnership could create largest nonprofit hospice provider in North Texas, expand servicesKERA News; by Abigail Ruhman; 3/11/26A new partnership between two nonprofit providers could expand hospice care services in North Texas as the state’s population of older adults continues to grow. Forefront Living, a nonprofit senior living facility with more than 100 patients, will wind down its hospice care as the Visiting Nurse Association of Texas, or VNA, becomes its preferred partner for the service. VNA will also take over management of Dallas’ first independent, residential hospice care center.

Dignity in motion: How hospice care and wheelchair transportation shape senior comfort in Tacoma US Culture & Style Today, Tacoma, WA; Press RElease; 3/11/26 For seniors approaching the most sensitive stages of life, the quality of care is defined not only by what happens inside a home or medical facility but also by how individuals move between places. Transportation during hospice care and assisted living transitions must protect dignity, emotional calm, and physical safety. When medical transportation is handled with respect and patience, the entire care experience becomes gentler for both seniors and their families. ... 

Nursing's moral agency cannot be outsourced to AI, study warns Medical Xpress; by University of Pennsylvania School of Nursing; 3/10/26 As artificial intelligence (AI) rapidly integrates into clinical settings—from predicting patient outcomes to deploying humanoid "robotic nurses"—an article published in the Hastings Center Report warns that the core of nursing, its moral agency, must remain a human-driven responsibility. The article, What Does Moral Agency Mean for Nurses in the Era of Artificial Intelligence?, explores the growing tension between advanced algorithmic capabilities and the ethical obligations of the world's most trusted profession. While AI systems can now simulate empathy and generate context-aware responses, Penn Nursing's Connie M. Ulrich, Ph.D., RN, FAAN, the Lillian S. Brunner Chair in Medical and Surgical Nursing, Professor of Nursing, and Professor of Medical Ethics and Health Policy, and her co-authors argue that AI lacks sentience, intentionality, and accountability. The authors define a moral agent as a person capable of discerning right from wrong and being held accountable for their actions.

"Black box" artificial intelligence for mortality prediction: a mixed- methods study of palliative care team, patient, and caregiver perspectives Annals of Palliative Medicine; by Beatrice Bridge, Ahmed Y Alasmar, Lauren Gunn-Sandell, Regina M Fink, Stacy M Fischer, Elizabeth Juarez-Colunga, Eric G Campbell, Matthew DeCamp; 2/26/26 Background: New artificial intelligence (AI)-based mortality prediction algorithms could support both patients' prognostic awareness and person-centered palliative care. ... Results: Among 53 interviewees, 18 expressed only concern about black box AI-based prognostication, 17 expressed only unconcern, and 18 interviewees expressed mixed sentiments. Reasons for concern related to: data transparency, mistrust of machines or their creators, patient-clinician communication, bias, and accuracy. Reasons for unconcern related to: inexplicability not unique to AI, greater accuracy, not using AI in isolation, trust in science, and being evidence-based. Notably, "accuracy" and "trust" appeared in both.

Van Nuys address linked to nearly 200 hospice agencies, lawmaker says NBC Los Angeles-4, Los Angeles, CA; by City News Service; 3/11/26 A Van Nuys building is listed as the registered address for 197 hospice agencies, according to a state lawmaker who said Wednesday the discovery raises questions about oversight of California's hospice licensing system. Assemblywoman Alexandra Macedo, R-Tulare, said the agencies are registered at 14545 Friar St., where she said she visited the property after reviewing licensing records. ... The lawmaker said the situation highlights potential gaps in the state's oversight of hospice providers under Gov. Gavin Newsom's administration. In a statement to NBCLA, Newsom's office said the governor "cracked down on hospice fraud years." ... The statement did not comment on Macedo's findings at the Van Nuys building. NBCLA has also reached out to the Centers for Medicare and Medicaid Services for comment.

California hospice fraud: What to know as blame game erupts Newsweek; by Jasmine Laws; 3/11/26, updated 3/12/26 The social media platform X has been awash with criticism targeted at California Governor Gavin Newsom as a CBS News report detailed the extent of the state's hospice fraud problem. Newsom's office has been hitting back at the comments, reminding users that the state "cracked down on hospice fraud years ago," and has been pointing the finger at President Donald Trump, as his administration paused a hospice oversight program at the start of 2025. ... Responding to Newsom's office's comments, White House spokeswoman Abigail Jackson told Newsweek: "No one cares about Newscum’s boring X posts ..." While California has been in the spotlight for its hospice fraud, it is not the only state experiencing the problem—it is a nationwide issue. ... A report by the U.S. Department of Health and Human Services Office of the Inspector General in 2023 found that suspected hospice fraud amounts totaled an estimated $198.1 million nationwide. However, some states in particular have seen a surge in new operators, namely California, Arizona, Nevada and Texas, meaning these states are considered hotspots for potential hospice fraud.Editor's Note: This article aptly names the deeply partisan “blame game” now playing out across many media outlets. Hospice fraud is not a partisan issue—it is a human one. When hospice is exploited, it erodes trust in a field built on compassion and dignity at life’s most vulnerable moments. Political finger-pointing may generate headlines, but it does little to solve the problem. Stopping hospice fraud requires accountability, strong oversight, and a shared commitment to protect patients—and the integrity of hospice care itself.

[Japan] Half of hospice and palliative care unit inpatients' family members are surprised by death Journal of Palliative Medicine; by Satoko Ito, Tatsuya Morita, Masanori Mori, Isseki Maeda, Yutaka Hatano, Takashi Yamaguchi, Hiroyuki Otani, Tetsuya Yamagiwa, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Kento Masukawa, Mitsunori Miyashita; 3/10/26 Background: Sudden unexpected death can occur even among patients with advanced cancer receiving hospice and palliative care. How bereaved families perceive this remains unclear. ... Design/setting/subjects: We analyzed longitudinally linked data from a prospective cohort of advanced cancer patients in 23 palliative care units in Japan and a nationwide survey of bereaved families. Conclusions: Compared with physicians' perspectives, bereaved family members perceive death to be sudden or unexpected more frequently and differently, and their perceptions are associated with postbereavement mental health.

Bedford Hospice House seeks new partners Bedford Bulletin, Bedford, VA; by John Barnhart; 3/11/26The Bedford Hospice House will close on April 15, but this may not be the end. The hospice house was built as a community endeavor with Tom and Connie Messier spearheading the effort. The community raised the money to build a free-standing residential-style hospice house. The four-bedroom facility provided a home-like place where terminal ill people, who could not stay in their homes, could spend there last days. ... According to Amy Merrill Willis, President of the Board of Directors for Friends of the Bedford Hospice House, Cemtra notified them on Feb. 26, that hospice house would close.  ... "We remain very committed to the hospice house," she said. She said they are exploring options and have been in communication with the Bedford County Board of Supervisors. She said the supervisors are interested in maintaining it as a hospice house and she said her board hopes to find a new partner.

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