Literature Review

Impact of an inpatient telepalliative care consult service in rural hospitals: One state storyJournal of Hospice and Palliative Nursing; by Anup Bhushan, Scott D Hurley, Patrick J Coyne; 2/25Palliative care has become a standard of care for patients with serious illnesses. However, many rural hospitals do not have access to specialized palliative care consultation. This article describes the journey taken by a palliative care team to improve access to palliative care and overall patient outcomes at rural hospitals throughout the state of South Carolina by using the telehealth modality. The impact, challenges, and benefits of the program are discussed.

Palliative care consults in the Southeast: Lower readmissions despite increased length of stayJournal of Palliative Medicine; by Hillary E Davis, Heather Reed-Day, Erin W Jackson, R Eric Heidel, Justin Wolfe, Adam J Tyson; 3/25We aimed to understand how PC consultations in a southeastern program, affected by pandemic-related care delays, impacted common clinical performance metrics. Our cohort study using MS-DRG matching indicates that despite increased LOS, PC consultations were associated with significantly lower readmission rates. This suggests their potential to improve resource utilization, especially in regions affected by pandemic-deferred care.

Perspectives on the challenges of planning for and accessing long-term dementia care services through Medicaid and Medicaid WaiversJournal of Applied Gerontology; Justine Scattarelli, Kelly Moeller, Dana Urbanski, Marguerite DeLiema; 4/25 Formal long-term services and supports (LTSS) are essential to support older Americans with chronic conditions, such as Alzheimer’s disease and related dementias (ADRD). However, few older adults have saved enough to pay for LTSS, and navigating Medicaid eligibility criteria presents significant challenges. We conducted semi-structured, in-depth interviews with aging services professionals and caregivers of older adults with ADRD to assess challenges to planning for and accessing LTSS coverage through Medicaid and Medicaid waivers. Using concept mapping, three main themes were identified: (1) Proactive planning, (2) decision points, and (3) the application process. Participants described misconceptions about LTSS coverage, challenges with enrollment, and lack of information about eligibility affecting the LTSS planning trajectory. Results demonstrate a critical need for resources that help caregivers estimate costs and guide them through the eligibility determination, application, and spend down processes for Medicaid programs.

Exploring the impact of acquisition on quality of care among US home health agenciesHealth Services Management Research; by Debra Winberg, Jillian Torres; 5/25Throughout the United States and Europe, the home health care industry is rapidly consolidating, with merger and acquisition (M&A) activity on the rise. The consolidation of the industry raises questions about the impact that diminished competition may have on the quality of care being delivered. This study examines the impact of home health agency acquisition on quality of care among a sample of 10,184 home health agencies across the United States. Utilizing publicly available data from the Outcome and Assessment Information Set (OASIS) and the Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) from 2018 to 2022, this study investigates changes in clinical outcomes, organizational process measures, and patient experience. The findings suggest there is a modest 1.07 percentage point improvement in process measures post-acquisition, but no significant changes in outcome or patient experience measures among the 169 agencies that were acquired during the study period. These findings suggest that, while integration has the potential to modestly improve home health process efficiency, there is very little benefit to patients.

Saturday newsletters focus on headlines and research - enjoy!

Health systems need radical transformation. Are C-suites ready? Becker's Hospital Review; by Laura Dyrda; 5/21/25Health systems faced with ever-thinning margins and uncertain financial future may be tempted to double-down on cost cutting as an immediate option relief. But for most, that’s not the best option. ... “Amid unprecedented volatility, resource constraints, and technological disruption, how can healthcare executives rapidly adapt and transform their organizations to sustainably deliver high-value care, optimize operational efficiency, and preserve workforce resilience and empathy?” posed Craig Albanese, MD, CEO of Duke University Health System in Durham, N.C. The question is urgent and complex. Hospital leaders are searching for connecting points with old friends, rivals, community organizations and other stakeholders to problem-solve together. They’re also pursuing larger strategic changes instead of small fixes to truly build sustainable organizations for the future. ...

Inaugural walk raises awareness for pancreatic cancer Columbus Jewish News, Beachwood, OH; by Becky Raspe; 5/21/25 On April 30, Wexner Heritage Village held its inaugural Zusman Hospice & Pancreatic Cancer Walkathon fundraiser. Held at Bexley’s Schneider Park, the event was held in memory of Rob Cohen, brother of Wexner Heritage Village and Zusman Hospice’s volunteer coordinator Judi Koval. Cohen died three years ago from pancreatic cancer ... under the care of Wexner Heritage Village’s Zusman Hospice “at the end of his days.” Organizing the walk to honor her brother, the event date also would’ve been her brother’s birthday, she said. 

‘Marathon’ effort to refine end-of-life wound coding runs on McKnights Long-Term Care News; by Kimberly Marselas; 5/28/25 Two key wound care groups are finalizing a proposal for new codes that would help skilled nursing providers avoid newly created diagnoses gaps for end-of-life skin breakdown that could lead to missed reimbursement and potential liability risks. The push comes a year and a half after nursing homes won the right to stop coding wounds that occur as part of dying as pressure injuries, which can hurt their quality ratings. But they also lost any way to code or acknowledge treatment of such skin failure in the Minimum Data Set. ...

‘Wake-up call’: Aggressive cancer care common at end of life, supportive care lackingHealio; by Josh Friedman; 5/22/25Nearly half of people with advanced cancer receive aggressive care at the end of life, a rate little changed from a decade ago. At the same time, use of palliative or supportive care remains rare, despite increasing evidence that they are a key component of high-quality, patient-centered care. ... Meanwhile, two other studies showed oncologists’ individual practice patterns and institutional resources can play a significant role in determining which patients receive systemic therapy or early palliative care at the end of life.

Proposed California budget calls for prior authorization for hospice in Medicaid Hospice News; by Jim Parker; 5/22/25 The proposed California budget would require prior authorizations for hospice care within the state’s Medicaid program. Currently, Medicaid managed care plans who provide coverage through the state’s Medicaid system, Medi-Cal, may not perform prior authorizations for hospice. California’s Department of Health Care Services (DHCS) indicated in a 2025-2026 budget revision that this could save $25 million over the next two years and more than $50 million in the long term. If enacted, this would make California the first state in the nation to implement such a rule, according to the California Hospice & Palliative Care Association (CHAPCA). The association contends that the anticipated $25 million in cost savings is “speculative and fails to account for the downstream costs and systemic burdens this proposal would create,” according to a position paper shared with Hospice News. ... CHAPCA recommended to the state government three alternative approaches: ...

Finding Solutions: Local group makes flowers for everyone WRDW-12 & WAGT-26, Augusta, GA; by Zayna Haliburton; 5/21/25 Flowers are something that can put a smile on someone’s face, whether you’re receiving or giving them. For one local group, they’re making bouquets to bring to nursing homes, shelters and hospitals. They’re now finding solutions in asking the community to consider donating their leftover flowers from weddings and events in order to brighten someone else’s day. “These are going to go to hospice patients that a part of Enhabit Augusta, ..." said Patricia Proctor, co-owner of El Rey and founder of non-profit Corazón Bonito ... which translates to "beautiful heart" in English. 

Music as medicine: Jenny Chen, Tyler Jorgensen, & Theresa AllisonGeriPal podcast; by Eric Widera, Alex Smith; 5/22/25As you know, dear listeners, I love music. We start each podcast with a song in part to shift the frame, taking people out of their academic selves and into a more informal conversation. Well, today’s guests love music at least as much if not more than me, and they each make a strong case for music as medicine. Jenny Chen is a palliative care fellow at Yale who regularly sings for her seriously ill patients... Tyler Jorgensen not only plays music for his patients, starting out with just pulling up a tune on his iPhone, he and others at UT Austin and Dell med now wheel a record player into patients rooms and play vinyl, taking patients back to the sounds and routines – think taking the record out of the sleeve, placing the needle in the groove – of younger days... And Theresa Allison is a geriatrician and ethnomusicologist who studies the role of music for people with dementia.

Memorial Day 2025: Resources, events, and ways to honor our fallen heroes Hope for the Warriors; retrieved from the internet 5/22/25 Each year, as the last Monday of May approaches, we are reminded that Memorial Day is more than just the unofficial start of summer. It is a sacred time to honor the brave men and women who made the ultimate sacrifice for our freedoms. Ways to Honor and Remember: