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.)

* CEO, Hildegard House, nonprofit, Louisville, KY

Identifying key components of neuropalliative care fellowship using nominal group techniqueJournal of Pain & Symptom Management; by Sachi Y Gianchandani, Jocelyn M Jiao, Kwame O Adjepong, Yaowaree L Leavell, Jessica M Besbris, Neha M Kramer, Joel N Phillips, Paul M Vermilion; 2/26There is no standardized curriculum for neurology-focused palliative care training. An adapted nominal group technique (NGT) was used to collect and rank responses to 2 key questions: "In designing the ideal dedicated neuropalliative care clinician training experience, what core components should be included?" and "When a general palliative care fellowship has a neurologist in their program, how could the program/program director potentially tailor the year to their unique needs?" For both key questions, the top-ranked responses included: dedicated outpatient neuropalliative care experience, mentorship from faculty with expertise in neuropalliative care, and a core didactic curriculum that includes neurology-specific content. Additionally, appropriateness for certification in hospice and palliative medicine was identified as crucial.

Effects of psychoeducation on burden, depression, and anxiety in informal caregivers of patients with dementia: A systematic review of randomized controlled trialsWestern Journal of Nursing Research; by Hyeyeon Shin, Chanchanok Wandee, Kathy D. Wright, Dónal P. O’Mathúna; 2/26As dementia rises globally, caregivers face prolonged and demanding responsibilities, increasing their risk of burden, depression, and anxiety. We aimed to identify the effectiveness of psychoeducation on burden, depression, and anxiety among informal dementia caregivers. This review clarifies the benefits of psychoeducation to inform the development of effective, targeted interventions. Psychoeducation offers dementia-related information, behavior management strategies, and caregiver support to improve mental health and caregiving effectiveness.

The business case for family caregiver skills training: Results from a multisite trial in the Veterans health care systemJournal of the American Medical Directors Association; Brystana G Kaufman, Michael A Lourie, Kasey Decosimo, Cynthia J Coffman, Joshua Dadolf, Matthew Tucker, Leah Christensen, Virginia Wang, Kelli D Allen, Susan N Hastings, Courtney H Van Houtven; 2/26Increasing caregiver training programs is valuable; however, even minimal health insurance cost-sharing can reduce access for those who need it most. We evaluated costs from the VA perspective, in which veterans and caregivers do not face high out of-pocket costs. Outside the VA, Medicare beneficiaries with care needs and caregivers do face these costs, potentially exacerbating health disparities. Integration and documentation of all caregivers in need of training is needed to support the systematic implementation of programs. Policies like the RAISE Family Caregivers Act encourage health systems to identify and provide necessary skills to family caregivers of hospitalized patients; yet, few health systems include a caregiver field in their EHR. As the need for caregiver training increases, health systems may leverage new reimbursement mechanisms to support the financial feasibility of delivering evidence-based caregiver training programs.

Hospice and palliative care during COVID-19 in New York City: Clinician-reported patient and family experiences and lessons for future crisesAmerican Journal of Hospice and Palliative Care; by Junyi Lin, Shih-Yin Lin, Daniel David, Laura T Moreines, Emily Franzosa, Abraham A Brody, Melissa D Aldridge, Dena Schulman-Green; 2/26The COVID-19 pandemic complicated hospice and palliative care (HPC) experiences of patients and family caregivers. We sought to understand HPC professionals' perceptions of patients' and family caregivers' HPC experiences during the COVID-19 pandemic in New York City and to make recommendations for improving HPC delivery during future public health crises.

[Italy] Vicarious post-traumatic growth in health professionals facing their patients’ end of lifeEuropean Journal of Trauma & Dissociation; by David Faggi, Gabriella Aprea, Chiara Fioretti; 3/26This study explored forms of vicarious post-traumatic growth perceived by professionals working in EoL [end of life] care settings. The findings indicate the presence of positive transformations, consistent with the construct of vicarious post-traumatic growth, among professionals who work daily in contact with patients’ suffering and finitude. The four themes identified (care as witnessing and mission; learning to live with death anxiety; personal vulnerability and resources; and authentic communication  [with terminally ill patients].The authors discuss the results, considering clinical implications and the potential role of post-traumatic growth in protecting healthcare professionals from distress and psychological suffering due to daily contact with death and dying.

[Canada] Cultural safety in practice: Providing quality health care for First Nations, Inuit, and Métis children and youth FreePaediatrics & Child Health; by Emilie Beaulieu, Sara Citron, Ryan Giroux, Cheyenne Laforme, Amber Miners, Brett Schrewe, Elizabeth Sellers; 2/26In Canada, cultural safety in health care has emerged in response to the racism and systemic discrimination that Indigenous peoples often face when accessing care. Grounded in cultural humility, antiracism, and trauma-informed care, cultural safety aims to ensure that Indigenous children and youth receive equitable, quality care. Paediatric health care providers can pursue building a culturally safe practice by applying the ‘learn, self-reflect, and act’ framework. They should also consider the home environment, language, and cultural heritage of each child, youth, and family seen in practice, alongside the barriers to and facilitators of healthy living that Indigenous children and youth experience in Canada. Being mindful of health care system policies and practices—and how they affect patient care both locally and historically—is an important step toward offering culturally safe care in any practice setting.

The ASCENT Consortium: A new resource to support palliative care science across the lifespanJournal of Pain and Symptom Management; by Jean S Kutner, Melissa D Aldridge, Abraham A Brody, Chris Feudtner, Kimberly Johnson, Stacy M Fischer, Susan Lysaght Hurley, Alexis Bakos, Elena M Fazio, Karen A Kehl, Sandra A Mitchell, Elizabeth A Necka, Brennan Parmelee Streck, Chandra Keller; 2/26The ASCENT Consortium was funded by the National Institutes of Health (NIH) in August 2025 with the goal of advancing palliative care (PC) research, evidence, implementation and practice to improve care of persons with serious illness and those who care for them across the lifespan. ASCENT aims to: (1) Develop and coordinate the national scientific infrastructure and community needed to advance PC research... (2) Generate new PC research knowledge and methodologies... (3) Foster career development and impact of the PC scientist workforce by funding career development and pilot and exploratory awards... (4) Disseminate PC research findings and facilitate subsequent implementation via a multi-pronged approach...

Bayada offers scholarship program to address nursing shortage Williamsport Sun-Gazette; by Matthew Corter; 3/17/26 In the wake of the COVID-19 pandemic, many industries experienced a shrinking workforce, and one of those hardest hit by the trend was the healthcare field. ... One of the biggest gaps currently is in home health aides. ... To face the shortage head on, Bayada has recently increased investment in its workforce and career development, including a scholarship program called Advance Through Nursing, which helps home health aides overcome financial and educational barriers on their path to becoming licensed practical nurses (LPNs) and registered nurses (RNs).

A greener afterlife: Local cemetery champions natural burial PBS - WUFT, Gainesville, FL; by Alexis Vivanco; 3/17/26 A wicker-woven casket emerged from a funeral hearse earlier this month at the Prairie Creek Conservation Cemetery for what would be the final resting place of Barbara Finley James. The coffin, modest and held together by various plant materials, was placed on a wooden cart. ... Members of several generations of the James family approached the casket, and placed hands on the various handles attached throughout. With a silent signal, the family began the march through the inclining dirt path to their loved one’s burial site. ... Natural burials, also known as green burials, are an alternate form of end-of-life care that champion cleaner funeral practices. The three characteristics that distinguish a natural burial are no embalming, no vaults, and all burial containers used must be biodegradable. 

Executive Personnel Changes - 3/20/26

Scotland rejects assisted dying at final stage: MSPs cite coercion fears and palliative care gaps in decision Newser; by Arden Dier; 3/18/26 Scotland has just turned down a chance to become the first part of the UK to allow assisted dying despite widespread support among the public. After five debate sessions and a rare Friday sitting, members of the Scottish Parliament rejected the Assisted Dying for Terminally Ill Adults (Scotland) Bill late Tuesday by 69 votes to 57, ... The free vote cut across party lines, ... Opponents repeatedly warned of coercion ... and arguing efforts should instead focus on better end-of-life care. Supporters ... shared personal stories of family members' suffering, insisted robust protections—including doctor checks to determine whether a person was being coerced—were built in.Editor's Note: Scotland's debate resonates with those throughout the U.S. and other countries. I invite you to revisit a "most read" article from our newsletters, "PositivelyJAX Award: The purple bench of Compassionate St. Augustine." Pair these with Daniel Goleman's "cognitive empathy," for which you might not agree--or feel it the same as another--but you do seek to learn and understand the other person's perspective.