Literature Review

Providence Care appoints Werner Freymann, Jr. as new Chief Executive Officer Morningstar; by Business Wire; 12/10/25 Providence Care, a leading hospice, palliative and primary care for seniors organization, today announced the appointment of Werner Freymann, Jr. as its new Chief Executive Officer. In the role of CEO, Werner will lead the company’s strategic direction and drive continued growth and innovation across its continuum of care for the elderly wherever they call home. Mr. Freymann brings more than 25 years of executive leadership experience, previously serving as SVP of Discovery at Home. 

4 hospice buyers acquire Traditions Health Hospice News; by Jim Parker; 12/3/25 Traditions Health has been acquired by four hospice providers, each dividing the company’s assets across their geographic footprints. The Care Team, VitalCaring, LifeCare Home Health Family and Mission Healthcare have each purchased a portion of Traditions Health’s locations. Financial terms of these transactions are undisclosed. Traditions was formerly a portfolio company of the private equity firm Dorilton Capital Partners. 

Medicare's AI prior authorization pilot sparks backlash over incentives to deny care Complete AI Training | Insurance; by Joren Erne; 12/7/25 CMS will pilot AI prior auth in traditional Medicare across AZ, NJ, OH, OK, TX, WA through 2031. Expect tougher reviews, vendor incentives, and pushback on denials and delays. ... For insurance professionals, this is a signal: CMS is importing private-plan utilization tactics into fee-for-service Medicare, with financial incentives tied to denial-driven cost savings. Expect policy, operations, and provider relations to feel it. 

Hospice margins dropping despite utilization gains Hospice News; by Jim Parker; 12/9/25 Hospice margins are falling despite record-high utilization, according to data from the Medicare Payment Advisory Commission (MedPAC). The commission has released its draft recommendations to Congress, repeating its annual call to eliminate hospice payment rate increases in future years. “For fiscal year, 2027, Congress should eliminate the update to the 2026 Medicare base payment rate for hospice,” MedPAC indicated in its draft recommendations. ... The average Medicare fee-for-service margin for hospices fell to 8% in 2023, down from 9.8% in 2022 and 14.2% in 2020, according to MedPAC. Among for-profit providers, the average 2023 margin was 13.7%, whereas nonprofits in aggregate showed a loss at -1.3%. These numbers exclude cap overpayments and non-reimbursible costs. These declines occurred during a time of record-breaking demand. Hospice utilization in 2024 reached the highest rate it has ever seen at 53%, MedPAC reported. More than 1.8 million Medicare decedents received hospice care that year for a total of 148 million days of service. [MedPAC 12/5/25 report here.]

Poured out and given: The lived experience of self-care among hospice nurses in rural Appalachia Journal of Hospice and Palliative Nursing; by Amanda Camden, Sandra P Thomas, Lisa C Lindley, Lisa Davenport, Ali Winters; 12/5/25, Online ahead of print Hospice nurses encounter profound challenges that make self-care both essential and deeply complex. ... The findings suggest that practicing self-care must be augmented by other actions such as systemic changes, caseload limits, leadership training, and structured emotional support systems. This study highlights the urgent need for health care systems to prioritize hospice nurses' well-being and help sustain compassionate nursing care.

AARP: 55 percent of family caregivers use tech to coordinate care McKnights Home Care; by Donna Shryer; 12/9/25 Technology adoption is surging on both sides of the caregiving equation. AARP estimates there are about 63 million unpaid caregivers nationwide, and among those caregivers age 50 and older, 55% now use one or more digital tools to manage routines, coordinate care or track health. Among all adults age 50+ (unpaid caregivers and care recipients), 78% say they rely on technology to stay connected with friends and family, according to AARP’s newly released 2026 Tech Trends and Adults 50-Plus report.Guest Editor's Note, by Judi Lund Person: As AARP points out, today’s caregivers are increasingly likely to use technology to coordinate care for their loved ones. Are hospice and palliative care providers up to the challenge – if your plumber can notify you that they are 15 minutes away, is there technology in place that will alert the caregiver that the hospice nurse or aide is 15 minutes away? How are you equipping your care teams to communicate with caregivers effectively, efficiently, and securely? Remember, a CAHPS Hospice question is, "How often did the hospice team let you know when they would arrive to care for your family member?"

Healthcare fraud enforcement trends to expect in 2026 JD Supra; by Arnall Golden Gregory; 12/8/25Key Takeaways

CHAP celebrates 60 years in home-based care Community Health Accreditation Partner (CHAP); email and website; 12/5/25 This year, CHAP marked a milestone that speaks volumes about our legacy and our future: our Diamond Jubilee. Sixty years of progress, partnership, and innovation came to life as our incredible team gathered to celebrate not just an anniversary, but the people who make our mission possible every day. It was a moment to honor the tradition that began in 1965 and continues to shape home-based care across the nation; a tradition built on excellence, compassion, and a shared commitment to the providers we serve. As we reflected on six decades of impact, the celebration reminded us of something even more powerful: the strength of our present and the promise of what’s next.Editor's Note: Hospice & Palliative Care Today celebrates CHAP immeasurable contributions to improving patient / caregiver / family care, staff education and standards, organizational systems, and more!

No matter at what stage of our journey,for each of us the inevitability of dyingis always there, like the blank wallof an imprentrable fortress.Or an unexplored planet.Or a looming cliff face before us,with few visible toeholds...Myself, I'm hoping for an airy work spacewith lots of light and booksand some flowering potted plants.And a PC that never gets obsolete.~ Luci Shaw, from Adventures of Ascent: Field Notes from a Lifelong Journey (a poet who died recently, just prior to her 97th birthday)

Value bias and ethnocentrism and its effect on advance care planning: Mind the gapJournal of General Internal Medicine; Jeffrey T Berger, Dana Ribeiro Miller; 11/25After decades of efforts by academic and professional organizations and by governmental agencies to promote advance care planning, less than half of adults in the USA have formally executed advance directives. For patients who have completed these documents, studies find limited impact on end-of-life care. In this paper, we discussed ways in which bias towards certain values in the health care enterprise including ethnocentrism, the centering of one set of cultural norms, may contribute to the public's ambivalence and the relative inefficacy of advance directives. We offer a more expansive perspective on this aspect of clinical care with the goal of serving all patients more effectively.

Adolescents' and young adults' perspectives on decision-making and the emotional experience of having advanced cancerJournal of Pain and Symptom Management; by Nelda Itzep, Jessica Moore, Colleen Gallagher, Michael Roth, Peyton Martin, Mike Hernandez, Karen M Moody; 12/25Adolescents and young adults (AYAs) with advanced cancer represent a unique and vulnerable population. Little is known about the optimal approach to support their medical decision-making needs... Most participants reported acceptance and peace with their illness, yet many struggled with changes in physical appearance, the unfairness of getting cancer, and angry feelings related to their illness. Participants also reported high levels of therapeutic alliance with their doctors. These AYAs reported remaining hopeful and future oriented despite their prognosis. They also reported a strong belief that AYAs should be involved in decision-making.

Pediatric imminent death donation: Is it ethical?Journal of Pain and Symptom Management; by Gabriel Chain, Laura Pucillo, Mindy Dickerman, Richard James, Stephen Dunn, Elissa G Miller; 12/25Imminent death donation (IDD) is a form of organ donation that would occur just prior to the withdrawal of life-sustaining technology (WOLST). While IDD may offer a valuable opportunity for organ donation, for example when donation after circulatory death (DCD) is not feasible, it raises significant ethical concerns, particularly in pediatric cases... Clinicians from critical care, transplant surgery, palliative care and our hospital ethics committee offer differing views on how to address [a complex case].

Inpatient palliative care and post-operative healthcare utilization among older surgical patientsAnnals of Surgery; by Orly N Farber, Hiba Dhanani, Mengyuan Ruan, Masami Tabata-Kelly, Cameron Comrie, Amanda J Reich, Kate Sciacca, Tamryn F Gray, Lyle Suh, Stuart R Lipsitz, Elizabeth J Lilley, Christine S Ritchie, Charlotta Lindvall, Zara Cooper; 11/25Summary background data: National guidelines recommend palliative care processes for patients with serious illness undergoing major surgery. However, outcomes associated with palliative care delivery to elective surgical patients are understudied... Among 1,082 patients, 54.1% had a documented surrogate decision-maker, 4.3% had code status limitations, 2.6% had goals of care conversations, and <2.0% had assessment for hospice or palliative care consultations... Inpatient palliative care processes such as surrogate decision maker-designation are not associated with changes in one-year healthcare utilization after elective surgery.