Literature Review

'You will NEVER be forgotten': 26-year-old Savannah mom in hospice care has died ABC WJCL-22 News, Savannah, GA; by Graham Cawthon; 12/13/24 A young Savannah mother who entered hospice care earlier this month has died. WJCL began following the story of 26-year-old Sara Long last year. Long was diagnosed with a rare kidney disease at the age of 13. Six years later, her mother donated a kidney to her. But the new organ failed.“We were expecting to have more time, you know," Sara told WJCL earlier this month. "I was just hoping to make it through the holidays, honestly." ... "I would rather have 26 really good years full of adventure and full of meaning and full of love and just the most beautiful people and I'm so glad that I got that instead of 100 mediocre ones," she added.On Friday, Sara's husband Justin confirmed that she had passed away. "December 12, 2024 at 10:20pm Sara Long passed away. I held her in my arms and told her I loved her as she took her last breath. Her kind and loving nature continues through our daughter Riley and me as she has shown me that men can be calm and loving. She has shown me that I can be the greatest dad and has shown everyone around her what true love and kindness is. I'm glad she lived a great 26 years instead of 100 mediocre ones. Thank you, Sara for giving me the absolute best 7 years of my life and the most beautiful daughter. You will NEVER be forgotten. I love you." Editor's note: We posted Sara's powerful video and quote in our newsletter on 12/6/24. Click here for her profound, inspirational video.

One day you will tell your story of how you overcame what you went through and it will be someone else's survival guide. ~ Brene Brown

Humana in the headlines: 10 updates Becker's Payer Issues; by Andrew Cass; 12/10/24 From Cigna quashing merger speculation to naming a new CFO, here are 10 updates on Humana that Becker's has reported since Oct. 30: 

Beshear unveils paid leave plan for state workers with new child or serious illness Spectrum News 1, Frankfort, KY; by Associated Press; 12/12/24 Kentucky plans to provide state employees with paid time off so they can bond with a new child or deal with a serious medical situation, Gov. Andy Beshear, D-Ky., said Thursday. The added benefit will give state executive branch workers up to six weeks of paid leave, available in three intervals during an employee's career, the governor said. New hires will immediately become eligible for six weeks of paid time off, he said. Another six weeks of paid leave will be offered two more times: once employees reach 10 years of service and again at 20 years. 

Today's 10-Second Question 12/24What hospice or palliative care stories or trends do you predict we'll see in 2025? Themes might include clinical, quality, regulatory, reimbursement, ethics, heartwarming, etc. (Click the link above to participate! Responses will be shared in January.)

New NIH-funded program will train ASU students for the future of AI-powered medicine Arizona State University - ASU News; by Richard Harth; 11/26/24 The medical sector is increasingly exploring the use of artificial intelligence, or AI, to make health care more affordable and to improve patient outcomes, but new programs are needed to train engineers and biomedical researchers for this future. A team at Arizona State University has received a $2.35 million award from the National Institutes of Health (NIH) to establish just such a pioneering program to train doctoral students to meet these needs. The program will welcome its first cohort of PhD students in the spring of 2025.

‘Open door’ policy for staff key to preventing hospice False Claims Act complaints Hospice News; by Jim Parker; 12/13/24 Taking employee concerns seriously about patient eligibility and other issues can help prevent hospices from becoming involved in a False Claims Act case. The overwhelming majority of False Claims Act cases involve qui tam whistleblowers, usually a current or former employee who observed alleged malfeasance or errors. In a qui tam action, a whistleblower, called a “relator” by the courts, files a False Claims Act suit on behalf of the government and possibly receives a portion of any funds recovered by the government via the lawsuit, typically ranging from 15% to 25%. In Fiscal Year 2023, for example, these cases recovered $2.3 billion of the total $2.68 billion recouped by the government in FCA settlements and judgements, according to a report from the law firm Polsinelli.

'A blessing': Hospital beds find new homes in families who had been praying for them Austin American-Statesman, Austin, TX; by Nicole Villalpando; 12/13/24 Ron McDaniel had been trying to find a place for the hospital bed both his dad, Robert, and brother, Gary, had used in the assisted living facility where they were before they died. His father was a Navy veteran who was burned over 30% of his body during World War II. His brother had severe brain damage from a car accident in 1976 and was a quadriplegic. The electronic hospital bed with the extra comfortable mattress and the trapeze bar needed a new home. Ron McDaniel wanted it to go to a veteran or a veteran's family because it originally came from the Veterans Affairs, but he tried organization after organization with no luck. Meanwhile, Sandra Daniels was in desperate need of a hospital bed for her mother, Bertha Woodward, 87, who has heart failure, problems with her kidneys and limited mobility caused in part by neuropathy in her feet. Daniels could not afford a hospital bed but had been trying organization after organization for a year and came up empty. She had recently called AGE of Central Texas to see if they might have a hospital bed. ...Editor's note: Organizations who helped include 26th Statesman Season for Caring, Austin Palliative Care, ATX Firefighter Moving, AGE of Central Texas.

Embracing life when nearing death The Aspen Times - Snowmass Sun; Aspen, CO; by Allison Daily; 12/13/24 Receiving a terminal diagnosis is one of life’s most profoundly difficult moments — a collision of disbelief, fear, and uncertainty. With some diseases, there’s a glimmer of hope for a miracle; with others, the focus shifts to navigating the process ahead. When Rita Hunter first asked to meet with me, I had no idea she had been diagnosed with Amyotrophic Lateral Sclerosis (ALS) or Lou Gehrig’s Disease. As we settled into my office, she got straight to the point: “I want you to help me with this last part of my life.” I left our first session rattled, but we established a clear understanding over time. She needed someone with whom she could be brutally honest — someone to discuss, without judgment, what she was willing and unwilling to endure. ... In her final days, her body let her know when it was time, and she showed extraordinary grace. She was a gift to this community, and she was a gift to me. She taught me more than I could ever give to her. Rita had become a model of how to live fully, even in the face of an unchangeable reality. Editor's note: Click on the title's link to read this inspirational story, and to learn this clinician's "treehouse" imagery intervention.

Cancer mortality in Louisiana’s correctional system, 2015-2021JAMA Network Open; Totadri Dhimal, MD; Paula Cupertino, PhD; Zijing Cheng, MS; Erika E. Ramsdale, MD; Bailey K. Hilty Chu, MD; Brian J. Kaplan, MD; Andrea Armstrong, JD, MPA; Xueya Cai, PhD; Yue Li, PhD; Fergal J. Fleming, MD, MPH; Anthony Loria, MD, MSCI; 11/24Nearly 2 million individuals are incarcerated annually in the US, predominantly low-income men from racial and ethnic minority backgrounds. The prison population is also aging, with those aged 55 years or older projected to constitute one-third of all incarcerated individuals by 2030. Imprisonment is associated with accelerated physiological aging, and national data show that incarcerated individuals have 22% higher odds of receiving a cancer diagnosis compared with the general population. Our study found that the cancer-specific mortality rate among incarcerated individuals in Louisiana was higher than the national rate but lower than the state’s, with the majority of these deaths occurring among those older than 55 years. Medical compassionate release remains an underutilized option, and the effect of providing a dignified death for families, health care professionals, incarcerated individuals, payers, and policymakers needs further evaluation.

The ISNP opportunity for hospice providers  Hospice News; by Jim Parker; 12/5/24 Hospice providers can collaborate with institutional special needs Medicare Advantage plans (ISNP) to reach patients who reside in long-term care facilities. ISNPs restrict enrollment to MA eligible individuals who, for 90 days or longer, have had or are expected to need the level of services provided in a long-term care (LTC), skilled nursing facility, a LTC nursing facility, intermediate care facility for individuals with intellectual disabilities (ICF/IDD), or an inpatient psychiatric facility. The nonprofit senior services organization Empath Health, which operates several hospices, recently partnered with the MA organization American Health Plans to bring their services to ISNP-enrolled patients.

Patient, caregiver, and clinician perspectives on the time burdens of cancer careJAMA Network Open; Arjun Gupta, MD; Whitney V. Johnson, MD; Nicole L. Henderson, PhD; Obafemi O. Ogunleye, MEd; Preethiya Sekar, MD; Manju George, MVSc, PhD; Allison Breininger, MA; Michael Anne Kyle, PhD, RN; Christopher M. Booth, MD; Timothy P. Hanna, MD, PhD; Gabrielle B. Rocque, MD; Helen M. Parsons, PhD; Rachel I. Vogel, PhD; Anne H. Blaes, MD, MS; 11/24Cancer and its care impose significant time commitments on patients and care partners. These commitments, along with their associated burden, have recently been conceptualized as the “time toxicity” of cancer care. Patients with advanced solid tumors spend approximately 20% to 30% of their days alive with health care contact. In this qualitative analysis of patients, informal care partners, and clinicians, participants highlighted the diverse sources of time burdens, how these time burdens affected care partners alongside patients, and how the time burdens extended to the wider network around them. Time burdens had outcomes ranging from causing psychosocial distress, and “seemingly short” ambulatory appointments turning into all-day affairs. These findings will guide the oncology community to map, measure, and address time burdens for persons affected by cancer.

Characteristics of health systems operating Medicare Advantage PlansJAMA Health Forum; Aaron Hedquist, MSc; Eric Yu, MPH; Pasha Hamed, MA; E. John Orav, PhD; Austin Frakt, PhD; Thomas C. Tsai, MD, MPH; 11/24Health care delivery has rapidly transitioned from independent physicians and hospitals to integrated delivery networks. More than three-quarters of inpatient facilities are affiliated with a health system. Nearly 1 in 7 MA [Medicare Advantage] beneficiaries are enrolled in system-operated MA plans, which remain a consistent source of Medicare enrollment. The findings of this study suggest that larger and church-affiliated health systems are associated with a higher likelihood of operating an MA plan. System-operated MA plans were associated with higher quality ratings and patient satisfaction than unaffiliated MA plans.