Literature Review

Surging hospital prices are helping keep inflation highWall Street Journal; by Melanie Evans; 5/16/24A 7.7% increase in prices at hospitals last month was the highest in 13 years. ... Hospitals didn’t raise prices as early in the pandemic as supermarkets, retailers and restaurants. But they have been making up ground since then. Their increases have contributed to stubbornly high inflation readings from the consumer-price index, which in April increased 3.4% from a year ago. Hospital prices specifically jumped 7.7% last month from a year ago, the highest increase in any month since October 2010, the Labor Department said Wednesday. ... Hospitals sat out the first waves of inflation that swept through the economy in recent years, though not by choice. Their prices were locked in under contracts with health insurers, for more than a year in some cases. As hospitals have renegotiated prices, inflation has taken hold.

Hospitals Are Refusing to Do Surgeries Unless You Pay in Full FirstWall Street Journal; by Melanie Evans; 5/9/24Now, more hospitals and surgery centers are demanding patients pay in advance. Advance billing helps the facilities avoid hounding patients to settle up. Yet it is distressing patients who must come up with thousands of dollars while struggling with serious conditions. Heather Miconi has seven weeks to come up with $2,000 to pay for surgery her daughter needs to breathe more easily. Merritt Island Surgery Center in Merritt Island, Fla., billed Miconi in advance of the adenoid and tonsil surgery. If she can’t pay for the surgery before it is scheduled to take place next month, the procedure will be put off. Miconi, whose insurance won’t cover the cost because she has a high deductible, works three jobs and doesn’t have savings to cover the cost. She is now appealing to strangers through a GoFundMe campaign for help. For years, hospitals and surgery centers waited to perform procedures before sending bills to patients. That often left them chasing after patients for payment, repeatedly sending invoices and enlisting debt collectors. Those who can’t come up with the sums have been forced to put off procedures. Some who paid up discovered later they were overcharged, then had to fight for refunds. Among the procedures that hospitals and surgery centers are seeking prepayments for are knee replacements, CT scans and births.

Caring for young caregivers, a hidden populationSTAT; by Kimia Heydari, Romila Santra; 5/9/24Of the estimated 48 million caregivers in the U.S., an estimated 14 million are under the age of 24. The growing burden of unpaid caregiving is increasingly falling on young people.

Upskilling and retraining for talent innovation in the AI ​​era Tech Trends Post; 5/13/24 According to a report from the IBM Institute for Business Value, more than 60% of executives say generative AI will disrupt the way their organizations design customer and employee experiences. Employees must change to meet these demands. Many are turning to AI upskilling – the act of providing the workforce with the skills and training to use AI to do their jobs. ... A 2024 Gallup poll found that about 25% of workers worry that their jobs could become obsolete due to AI. ... [This article outlines the following:]

Industry professionals reflect on five years of medical marijuana in Arkansas Arkansas Advocate; by Mary Hennigan; 5/13/24Since the launch of medical marijuana in Arkansas in 2019, more than three dozen storefronts have opened, at least 102,000 residents have registered for patient cards and revenue has topped $1.1 billion. The latest card count exceeds 102,000, and there’s no indication of a letup in new applications,  ... As of June 2023, one in three Arkansans with a patient card listed post-traumatic stress disorder as their qualifying condition, ... The next highest qualifying condition was intractable pain, or pain that has not responded to ordinary medications for more than six months, at nearly 30%. 

Utah man angry: "Why am I still alive?" Cat Country 107.3/94.9; by Andy Griffin; 5/10/24 George Ball (not his real name) is angry. He's dying soon, he knows that. But what he's really mad about is that he's still alive. "I signed the paper. I made the request," he said. "So, why am I still alive?" ... The 72-year-old Utahn recently had a heart attack (cardiac arrest), and was essentially dead for a few minutes before being resuscitated at a Utah hospital. Life-saving measures were taken, including shooting adrenaline into his heart. He was gone, but they brought him back. Happy ending, right? The only problem was, Ball had signed and certified a DNR -- a do not resuscitate order -- so that if he, well, died, heroic measures would not be taken to bring him back to life. ...

Nurse Practitioner care, scope of practice, and end-of-life outcomes for nursing home residents with dementia JAMA Health Forum - JAMA Network; by Cyrus M. Kosar, PhD; Bishnu B. Thapa, MPA, PhD; Ulrike Muench, RN, PhD; Christopher Santostefano, RN, MPH; Emily A. Gadbois, PhD; Hyesung Oh, MA, MBA; Pedro L. Gozalo, PhD; Momotazur Rahman, PhD; Elizabeth M. White, APRN, PhD; 5/10/24 Question: Is nurse practitioner (NP) care associated with end-of-life outcomes for nursing home residents with Alzheimer disease and related dementias (ADRD), and do these associations differ between states with full vs restrictive NP scope of practice regulations? Findings: The results of this cohort study including 334 ,618 US nursing home residents with ADRD indicated that decedents with greater NP involvement at end of life had fewer hospitalizations and higher hospice use. The adjusted differences in outcomes between decedents with extensive vs minimal NP care were larger in states with full scope of practice regulations than in states with restrictive regulations.

Care Synergy appoints Dr. Pradeep Rai as Chief Medical Officer Care Synergy Network; 5/13/24  Care Synergy announced the selection of Dr. Pradeep Rai, MD, as the company’s chief medical officer. Additionally, Dr. Rai will serve as The Denver Hospice’s (TDH) medical director as well. As Chief Medical Officer, Dr. Rai will lead clinical operations across all of Care Synergy’s hospice, palliative care, and home health affiliates. These affiliates include The Denver Hospice, Pikes Peak Hospice & Palliative Care in Colorado Springs, Pathways Hospice in Fort Collins, and the Colorado Visting Nurses Association (CVNA) which serves patients across the Front Range. He will also spearhead medical operations for Colorado PACE upon its anticipated Q4 2024 launch.

Sunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!

Retraumatization when an adult child cares for the parent who harmed them through serious illness or the end of lifeJournal of Pain and Symptom Management; by Jaime Goldberg, Jooyoung Kong; 5/24Adult children caring for a parent who harmed them through the parent's serious illness or the end of life are at high risk for experiencing retraumatization. This session will offer trauma-informed, culturally responsive, person-centered tools and techniques hospice and palliative care professionals can use to effectively identify, assess, and intervene with this often-overlooked population of caregivers.Publisher's note: This current article summary is for an upcoming AAHPM conference workshop. The study was previously published in JPSM 5/24 here.

A survey of Jewish attitudes and experiences relating to end-of-life care and the “right to die”American Journal of Hospice and Palliative Medicine; by Christopher M. Moreman, Ayona Chatterjee; 3/24We conducted a survey of Jewish attitudes towards, and experiences with, end-of-life care. Questions fell into three areas: (1) Expectations for Jewish end-of-life care; (2) Experiences with such care; and (3) Attitudes toward the “right to die.” Examining denominational differences in belief in, and adherence to, Halakha (Jewish law), we confirm many expectations described in the literature. We find notable nuances in specific areas of need across Jewish denomination, and in terms of acceptance of the withdrawal of life support vs assisted suicide. Care for the nuances of Jewish belief is indicated for effective and satisfying Jewish end-of-life care.

Association between physician age and patterns of end-of-life care among older AmericansJournal of the American Geriatrics Society; by Hiroshi Gotanda, Ryo Ikesu, Anne M. Walling, Jessica J. Zhang, Haiyong Xu, David B. Reuben, Neil S. Wenger, Cheryl L. Damberg, David S. Zingmond, Anupam B. Jena, Nate Gross, Yusuke Tsugawa; 4/15We found that differences in patterns of EOL care between ben-eficiaries cared for by younger and older physicians were small, and thus, notclinically meaningful. Future research is warranted to understand the factorsthat can influence patterns of EOL care provided by physicians, including ini-tial and continuing medical education.