Literature Review

Apparently healthy, but diagnosed with Alzheimer’s?The New York Times, by Paula Span; 3/4/24 New criteria could lead to a dementia diagnosis on the basis of a simple blood test, even in the absence of obvious symptoms.

Editorial: Illness trajectories in the age of big data The BMJ; by Peter Tanuseputro, Colleen Webber, and James Downar; 3/1/24For decades, healthcare providers have understood that patients follow typical trajectories of health decline as they approach the end of life, and they have used this understanding to help patients and families anticipate the dying process. Traditional trajectories focus on function or overall health status and include sudden death, terminal illness ..., organ failure ..., and frailty ... Two Education articles in the BMJ add novel dimensions to our understanding of health decline. Murray et al explain how declines in function do not always mirror declines in social, psychological, and spiritual dimensions. They also add a new trajectory, multimorbidity, to describe a person with conditions from multiple trajectories (such as heart disease from organ failure and cognitive impairment from frailty).

A whistleblower lawsuit cost ChristianaCare $47M. Why are whistleblower cases increasing? Delaware Online, by Esteban Parra and Xerxes Wilson; 3/4/24A former medical director specializing in neurosurgery at southern Delaware’s largest health care provider claims in a lawsuit that Bayhealth Medical Center misclassified “brain-dead” patients in order to overbill for services. ... [The whistleblower reported that] hospital officials discussed a "new hospital initiative" in which suspected "brain-dead" patients would be discharged and admitted to hospice before any declaration of brain death, according to the lawsuit. The scheme allowed for prolonged billing where previous billing ended with the patient’s death, the complaint states. [Please refer to the article for details.]

The top strategies healthcare organizations can use to reduce denials MedCityNews, by Laxmi Patel; 3/5/24Here are six actionable steps healthcare organizations can take to reduce their likelihood of denials and write-offs.

Providers meet with OMB to prevent ‘devastating’ effect of 80/20 provision McKnights Home Care, by Adam Healy; 3/4/24Home care stakeholders have been busy on Capitol Hill voicing concerns about a controversial provision of the proposed Medicaid Access Rule. The National Association for Home Care & Hospice and Home Care Association of America met with the Office of Management and Budget last week to discuss the Access Rule’s so-called 80/20 provision. The provision, if finalized, would require that 80% of Medicaid payments for personal care, home health and homemaker services be spent on workers’ compensation. “If that one provision is finalized as proposed, it would be so detrimental that we’d likely lose a significant portion of our service delivery base and people would go without care,” Damon Terzaghi, NAHC’s director of Medicaid HCBS (home- and community-based services) said in an interview with McKnight’s Home Care Daily Pulse. “It would truly be devastating.”

Veterans’ care new battleground in nursing home staffing mandate McKnights Long-Term Care News, by Kimberly Marselas; 3/5/24Two senators have introduced a bill to determine exactly what “unintended circumstances” could result for elderly veterans if a federal rule mandating staffing levels at all US nursing homes is allowed to proceed. ... The bill would require the VA to study potential risks associated with the proposed Center for Medicare and Medicaid Services rule — especially as they pertain to rural providers. The senators said the proposal would “unsustainably change staffing ratios at nursing homes.”

Home care nurse strike ends without deal Northwest Labor Press, by Mallory Gruben; 3/1/24Usually, PeaceHealth jointly bargains with the home health unit and a unit of about 1,500 hospital nurses, and all nurses are paid the same. But for this round of negotiations, PeaceHealth demanded that bargaining happen separately. Hospital nurses reached an agreement in August that raises wages 20.5% over four years. PeaceHealth’s latest offer to the home health nurses is a 14.75% raise over four years. [Erin] Grace [a nurse,] says without an equal contract for equal work, PeaceHealth will have difficulty attracting and retaining home care nurses. According to ONA, the unit has already lost a quarter of its members, and more say they plan to leave if a contract isn’t reached soon. 

Hospice launches Mothers Day tribute page Newrie.ie; 3/3/24Southern Area Hospice has launched an online tribute page ahead of Mother’s Day, providing a platform for individuals to remember their mothers, grandmothers, and mother figures who have passed away. Visitors to the Mother’s Day online tribute page can leave messages, share stories, and upload photographs of their loved ones. The page also allows individuals to read other dedications, fostering a sense of community and remembrance. 

Revolutionizing Elderly Care: Palliative Care's growth and integration into Value-Based ModelsBNN, by Olalekan Adigun; 3/5/24Amid the rapidly evolving landscape of healthcare, palliative care is undergoing a significant transformation, marking a new era in the management and delivery of healthcare services to the elderly. Dr. Jason Black, a seasoned family medicine practitioner with a specialized fellowship in geriatrics, is at the forefront of this change. Working for Gilchrist, a hospice and palliative care organization in Baltimore and central Maryland, Dr. Black embodies the integration of palliative care into the broader healthcare framework, emphasizing value-based care models.

Bill to legalize medical aid in dying fails to advance in General Assembly, won’t become law in 2024 ABC News 8, Richmond, VA; by Tyler Englander; 3/4/24A bill to allow terminally ill patients to ask for physician-assisted death, or “medical aid in dying,” failed to pass a House committee on Monday, meaning it won’t become law in 2024. The House Courts of Justice Committee agreed to continue Senate Bill 280 to 2025, ending its chances of final passage in this year’s session.

Scientists reveal that nearly all older Americans follow one of nine trajectories in their last three years of life SciTechDaily, by Rutgers University; 3/2/24A Rutgers Health analysis of millions of Medicare records has laid the groundwork for improving end-of-life care by demonstrating that nearly all older Americans follow one of nine trajectories in their last three years of life. “Identifying which paths people actually take is a necessary precursor to identifying which factors send different people down different paths and designing interventions that send more people down whatever path is right for them,” said Olga Jarrín, the Hunterdon Professor of Nursing Research at Rutgers and corresponding author of the study published in BMC Geriatrics.

What is Sustainable Health Care Design? gb&d; by Andrew Biro; 3/4/24Improving the sustainability of our health care facilities is not only imperative to addressing climate change, but it also helps create healthier, more productive societies that are better suited to providing accessible, equitable health care to all persons. These are the basics of sustainable health care design, including strategies for implementation, metrics for measuring sustainability, and a few examples of successful, sustainable health care projects from around the country. Editor's Note: This article features a photo from The Jack Byrne Center for Palliative & Hospice Care in Lebanon, New Hampshire.

Coverage denials in Medicare Advantage—Balancing access and efficiencyJAMA Health Forum; by Suhas Gondi, MD, MBA; Kushal T. Kadakia, MSc; and Thomas C. Tsai, MD, MPH; 3/1/24 Each year, millions of claims for medical services are denied by health insurance plans. Many denials may be justified as a necessary strategy to reduce wasteful spending from low-value care. However, denials may also delay diagnosis and/or treatment for patients, and appealing denials contributes to clinician workload and burnout. This tension is apparent in the Medicare program, where denials affect millions of beneficiaries who enroll in Medicare Advantage (MA).