Literature Review

PE sponsors of Comfort Keepers, New Day Healthcare are in home-based care for the long haulHome Health Care News; by Joyce Famakinwa; 5/13/24While some private equity investors have been sidelined by macro and micro headwinds, there are still plenty of PE firms invested in home-based care that like where they are.

Emerging leaders in hospice and palliative care AAHPM - American Academy of Hospice and Palliative Medicine; webpage source for various press releeases of individuals; 5/24AAHPM developed the Emerging Leaders in Hospice and Palliative Care program to recognize the exceptional work accomplished by the next generation of leaders and bring increased exposure to the specialty of hospice and palliative medicine. In 2014, the first class of Emerging Leaders was named. AAHPM seeks to recognize accomplished early career professionals and the next generation of hospice and palliative care leaders. This award recognizes new Emerging Leaders in recognition of their career accomplishments, involvement in the Academy, mentoring of residents and students, and participation in charitable work. [Click on the title's link for the list of 36 honorees.]Editor's Note: Do you work with or know any of these honorees? If so, please share this with them and your colleagues, along with congratulations from Hospice & Palliative Care Today! (Invite them to register for free--no strings attached--to our daily newsletter.)

The complexity of physician powerScience; by Laura Nimmon; 5/16/24Inequitable variation in physician effort and resource use is revealed. Power is present in all human relationships. Thus, there is no interaction in which power and its potential to exert influence is not relevant in medicine. Although the role of power in medical interactions is important, few studies investigate how physicians allocate effort and execute their power when interacting with patients. ... The nature of physicians’ relationships with patients is characterized as top down and asymmetrical (1). This unequal relationship is thought to be a product of physicians possessing legitimized expert knowledge and legal decision-making authority and patients who are reliant on care and services. Underpinning this power afforded to physicians is societal trust that physicians will always act altruistically and ethically toward patients.Publisher's Note: Also see the related article How power shapes behavior: Evidence from physicians by Stephen D. Schwab, Manasvini in the same issue. [They] investigate how physician power in the US Military Health System interfaces with sociological phenomena such as hierarchy, status, and authority. Their findings reveal the variability and complex mechanisms through which physician power is exerted, ultimately providing nuance about how the ethics of physician power is understood as it interfaces with other hierarchical systems of power.

Medical aid in dying to avoid late-stage dementiaJournal of the American Geriatrics Society; by Thaddeus Mason Pope, Lisa Brodoff; 4/24Many patients with dementia want the option of using medical aid in dying (MAID) to end their lives before losing decision-making capacity and other abilities that impact their desired quality of life. But, for over two decades, it has been widely understood that these patients cannot (solely because of their dementia diagnosis) satisfy three statutory eligibility requirements in all U.S. MAID laws: (1) decisional capacity, (2) the ability to self-administer the life-ending medications, and (3) a terminal condition with 6 months or less to live. Now, because of recent statutory amendments together with the use of voluntarily stopping eating and drinking (VSED) to quickly advance to a terminal condition, this dementia exclusion from MAID might no longer apply. If combining VSED and MAID is now a possibility for patients with dementia, then clinicians need more guidance on whether and when to support patients seeking to take this path. In this article, we begin to provide this guidance. 

Impact of a Nurse-Led Palliative Care Screening Tool on Medical Oncology UnitsClinical Journal of Oncology Nursing; by Kaitlyn Whyman, Katherine Thompson, Michelle M. Turner; 2/24There is a lack of early integration of palliative care in patients with advanced cancer, which has been shown to result in suboptimal quality of life across their disease continuum. Standardized palliative care screening tools are valuable for identifying patients with early palliative care needs but have yet to be adapted into standard practice in the oncology community. This project aimed to determine whether a nurse-led palliative care screening tool increased palliative care consultations, decreased the average length of stay, reduced readmission rates among adult patients with solid tumor malignancies, and improved knowledge and confidence among nurses regarding palliative care.

Training opportunities for managers in home health, hospice, and community-based care settingsThe Journal of Nursing Administration; by Ann M Nguyen, Alfred F Tallia, Tami M Videon, Robert J Rosati; 6/24The aim of this study was to identify areas for developing management skills-focused continuing education for managers working in home health, hospice, and community-based settings. For all 33 management tasks, managers with 6+ years of experience reported greater confidence than managers with 0 to 5 years of experience. Tasks with the lowest confidence were budgeting, interpreting annual reports, strategic planning, measuring organizational performance, and project planning. Managers were clustered into 5 "profiles." Management training is not 1-size-fits-all. Healthcare organizations should consider investing in training specific to the identified low-confidence areas and manager roles to better support and develop a robust management workforce.

We now no longer camp as for a night, but have settled down on earth and forgotten heaven. ~Henry David Thoreau

Hospice Readmission, Hospitalization, and Hospital Death Among Patients Discharged Alive from HospiceJAMA Network; by Elizabeth A. Luth, Caitlin Brennan, Susan L. Hurley, Veerawat Phongtankuel, Holly G. Prigerson, Miriam Ryvicker, Hui Shao, Yongkang Zhang; 5/24This retrospective cohort study of burdensome transitions following live hospice discharge found that non-Hispanic Black race, short hospice stays, and care from for-profit hospices were associated with higher odds of experiencing a burdensome transition. These findings suggest that changes to clinical practice and policy may reduce the risk of burdensome transitions, such as hospice discharge planning that is incentivized, systematically applied, and tailored to needs of patients at greater risk for burdensome transitions.

21 hospitals, health systems raising workers' pay Becker's Hospital Review; by Kelly Gooch; 5/20/24 The following hospitals and health systems have announced or shared plans for raising workers' pay this year. Note: This is not an exhaustive list. This webpage was last updated May 20. [Click on the title's link for the detailed list.]

Steward proposes timeline for selling assets in bankruptcy Modern Healthcare; by Caroline Hudson; 5/20/24Steward Health Care is seeing interest from potential buyers of its 31 hospitals, particularly in Massachusetts and Arizona, and it hopes to complete sales this summer. The health system, which filed for Chapter 11 bankruptcy protection earlier this month, also is in advanced discussions with UnitedHealth Group's Optum to buy physician network Stewardship Health. Optum, which had been negotiating with Steward before the bankruptcy filing, submitted a "stalking horse" bid. A stalking horse bid is the initial bid on a bankrupt company's assets that helps set the minimum price for other potential buyers. Steward also is in discussions with "various third parties" for its northern Massachusetts facilities, the health system said in a bankruptcy court filing last week.

Tuesday Health launches revolutionary Supportive Care solution with $60 million of strategic investment from healthcare leadersInvestors Observier; by PR Newswire; 5/21/24Tuesday Health, a pioneer in value-based care dedicated to transforming serious illness, has launched its innovative supportive care solution in partnership with Valtruis, Blue Venture Fund, Mass General Brigham Ventures , and CareSource. This alliance brings a $60 million strategic investment to Tuesday Health, fueling its mission to redefine supportive care for patients and caregivers facing serious illnesses. "Leveraging clinical expertise, advanced data solutions, and cutting-edge technology, while partnering with Ohio's largest Medicaid plan, its largest hospice provider and the unmatched palliative care experience of Mass General, Tuesday Health is dedicated to tackling one of healthcare's biggest challenges-providing support and care in the right setting, at the right time, for those facing serious illness", said Jim Wieland, CEO of Tuesday Health.Editor's Note: What is the difference between supportive care and palliative care? Click here for a description from ASCO, the American Society of Clinical Oncology. 

Educating the future of hospice and palliative carePortage.life; by Center for Hospice Care; 5/21/24This spring students at the University of Notre Dame gained insight into the delivery of care to patients and families dealing with serious advanced illnesses. The university, in partnership with Center for Hospice Care (CHC), once again offered the course “Introduction to Hospice and Palliative Care” that was designed by Dr. Dominic Vachon, Director of Ruth M. Hillebrand Center for Compassionate Care in Medicine and Mike Wargo, COO and vice president of the Hospice Foundation. The five-week class covered a variety of topics focused on hospice and palliative care and was taught by CHC staff including physicians, social workers, chaplains, bereavement counselors and other hospice and palliative care support staff.

How value-based models can aid palliative care team recruitment Hospice News; by Jim Parker; 5/22/24 A transition from fee-for-service to value-based payment models could help palliative care providers boost recruitment and retention. Providers walk a tightrope when it comes to ensuring that their palliative care services are financially sustainable, including the ability to attract and compensate staff at competitive rates. In today’s predominant reimbursement structure, palliative care programs are often loss leaders. But moving away from fee-for-service towards value-based payment could make a difference when it comes to hiring and retention, according to Dr. Jennifer Blechman, palliative care medical director at the Oregon-based nonprofit Partners in Care. ...