Literature Review

Medicare Advantage plan disenrollment: Beneficiaries cite access, cost, and quality among reasons for leavingHealth Affairs; by Geoffrey J. Hoffman, Lianlian Lei, Ishrat Alam, Myra Kim, Lillian Min, Zhaohui Fan, Deborah Levine; 6/25Medicare Advantage (MA) is growing in popularity, but it is seeing substantial plan disenrollments among high-risk Medicare beneficiaries. Understanding and addressing factors associated with disenrollment are crucial for improving MA access and quality but are complicated by data issues, including the inability to adequately assess beneficiaries’ perceptions of access and quality in MA... Difficulty accessing needed medical care was more strongly associated with MA-to–traditional Medicare exits than MA-to-MA plan switching. Dissatisfaction with access, cost, and quality was much more common for enrollees in poor health. These findings renew concerns about access to high-quality care for high-risk and other MA enrollees.

[Italy] Palliative Performance Scale predicts mortality in cardiac intensive care unitOpen Heart; by Laura Sofia Cardelli, Lorenzo Gamberini, Beatrice Dal Passo, Silvia Zagnoni, Francesca Sciarra, Federica Frascaro, Alice Vitagliano, Valeria Carinci, Maria Laura Canale, Gianni Casella; 6/25Patients with PPS ≤70 had significantly higher 1-year all-cause mortality and in-hospital all-cause mortality. The PPS is a reliable and independent predictor of mortality in CICU patients. Incorporating PPS into clinical practice may enhance risk stratification, guide decision-making and optimise resource allocation in this high-risk population.

The ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversy. ~ Martin Luther King, Jr.

I guess we all like to be recognized not for one piece of fireworks but for the ledger of our daily work. ~ Neil Armstrong

May we think of freedom, not as the right to do as we please, but as the opportunity to do what is right. ~ Peter Marshall

True heroism is remarkably sober, very undramatic. It is not the urge to surpass all others at whatever cost, but the urge to serve others at whatever cost. ~ Arthur Ashe

With freedom comes responsibility. ~ Eleanor Roosevelt

Those who deny freedom to others deserve it not for themselves. ~ Abraham Lincoln

America, you great unfinished symphony, you sent for me. You let me make a difference. A place where even orphan immigrants can leave their fingerprints and rise up. ~ Lin Manuel Miranda, as Alexander Hamilton, in Broadway's 2014 Hamilton

We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator, with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. ~ The Declaration of Independence, 1776

The Alliance responds to Senate passage of Reconciliation Bill National Alliance for Care at Home, Alexandira, VA and Washington, DC; Press Release; 7/1/25 The National Alliance for Care at Home (the Alliance) issued the following statement today in response to the Senate’s passage of the “One Big Beautiful Bill Act,” also known as the Reconciliation bill. “The Alliance is alarmed by the Senate’s passage of the One Big Beautiful Bill Act, which prioritizes misplaced budget cuts over the health and wellbeing of our most vulnerable. The legislation will reduce access to care and support for the millions of Americans who rely on home and community-based services (HCBS),” said Alliance CEO Dr. Steve Landers. ... “The Alliance continues to maintain that the complexity of the Medicaid program makes it nearly impossible to reduce expenditures by the amounts contemplated by this legislation – potentially exceeding $1 trillion over ten years – without impacting services to older adults and people with disabilities. The Alliance will advocate on behalf of Medicaid enrollees, families, and providers nationwide ...

Hospice of Redmond to host special presentation by Project Recover: Bringing missing military home The Source, Redmond, OR; 7/1/25 Hospice of Redmond is honored to announce a special presentation featuring Project Recover, an organization dedicated to finding and bringing home military personnel missing in action (MIA). The event will take place on Thursday, July 9, 2025, from 1:30-3:00 PM ... The presentation will feature Adrian De La Rosa, Chief Operating Officer of Project Recover, who will share insights into the organization's critical work. ... "At Hospice of Redmond, Veterans are near and dear to our hearts," said Jody Logsdon, Volunteer Coordinator at Hospice of Redmond. "We believe every veteran deserves to be honored, thanked for their sacrifice, and returned home with the dignity they’ve earned. ..."

July is a picnic and a red canoe and a sunburned neck and a softball game and ice tinkling in a tall glass. ~ Hal Borland