Literature Review

CMS clarifies physician referral authority, tightens attestation requirements in proposed hospice ruleInside Health Policy; by Jalen Brown; 4/11/25... The proposed rule would explicitly allow the physician member of the hospice interdisciplinary group (IDG) to recommend patients for hospice care, addressing a gap in current regulations over which physicians have that authority. While CMS already lets IDG physicians certify that a patient is terminally ill and eligible for hospice, the existing admission rules only name the hospice medical director or physician designee as authorized to recommend admission. CMS also wants to strengthen documentation requirements for hospice recertification, ... Starting at day 180 and every 60 days thereafter, Medicare requires a hospice physician or nurse practitioner (NP) to conduct a face-to-face visit with the patient before recertifying eligibility. After the visit, the clinician must provide a written attestation confirming that the visit occurred and was used to assess whether the patient still qualifies for hospice care. Under CMS' proposal, that attestation would also need to include the clinician's signature and the date signed, submitted as a clearly labeled section or addendum to the recertification form. 

The future of management is hybrid: Leading human-AI teams in a new era of work Holtz Communication + Technology; by Shel Holtz; 4/12/25 ... Consider healthcare, where an AI agent will draft post-visit follow-up patient care plans, schedule check-ins, send reminders, and flag unusual symptoms in post-visit surveys for review. The human nurse practitioner will review and personalize the follow-up plan, contact patients in need of emotional support or clarification, and make clinical decisions about concerns the AI has flagged. ... Healthcare managers will have to align clinical protocols with AI-generated outputs, ensure HIPAA compliance (in the U.S.), and train staff to interpret and override AI recommendations when necessary. ... With less busy work, managers should be able to to focus on those aspects of managing that require a human touch, shifting to leading and mentoring, employing soft skills over hard skills, as shown in this chart: [Management Task/Skill | AI-AGents - Strength | Human Managers - Strength]

Hospitalists in a bind when cancer prognosis hasn’t sunk inMedscape; by Jake Remaly; 4/15/25 When a patient with cancer is admitted to the hospital, the reason might not be related to the malignancy. But the hospitalist in charge sometimes becomes aware of a major disconnect: The patient, who they just met, does not grasp the severity of their cancer prognosis. On the one hand, the hospital medicine team and patient have advance directives and goals of care to consider, which may steer the course of the hospitalization and any use of hospice. The cancer prognosis — the patient might only have months to live, for example — could be a key component of those conversations. On the other hand, explaining the cancer situation should fall to the oncologist, right? ...

ECHO Health gifts $5 million to Quality of Life Campaign; Center for Community Engagement to be name Hospice of the Western Reserve, Cleveland, OH; Press Release; 4/10/25 Hospice of the Western Reserve has received a historic $5 million gift to its Quality of Life capital campaign from ECHO Health, the Westlake-based company founded by the late Bill Davis. This transformative contribution, the largest single gift in the organization’s history, will accelerate the completion of its new Hospice Care & Community Center on Cleveland’s Lake Erie shore. ... In recognition of this gift, the facility’s Center for Community Engagement will be named in honor of Bill Davis. 

Closing the gap in end-of life care coverage: The role of nonprofits in policy advocacy Forbes; by James Dismond; 4/14/25... As the demand for end-of-life care grows, so will the gap between the care that patients need and what they receive. ... Workforce shortages, restrictive regulations, outdated reimbursement models and misconceptions around hospice services are keeping millions of Americans from accessing quality hospice and palliative care services. ... These barriers disproportionately affect low-income families, rural communities and communities of color. ... Unlike for-profit entities, we can prioritize community needs over shareholders. We can prioritize patient well-being over profits—or, to say it more directly, we put people over profits. And I’ve seen firsthand how advocacy can drive progress. Nonprofits must engage in:

Brain activity before death: Do we see our lives flash? Time.News; interview with Dr. Eleanor Vance; 4/12/25 What flashes through our minds in the final moments of life? Could it be an intense reel of our most cherished memories or a profound sense of calm? Recent studies suggest that the brain may not simply shut down at death; instead, it could be engaged in a powerful replay of life’s most significant moments, offering a glimpse into the mysteries of consciousness and the human experience.

It's April 15, tax day. The federal tax code is over 74,000 pages long. But stick with it because after page 72,000, it gets really good. ~ Conan O'Brien

Why AI demands a new breed of leadersMIT Sloan Management Review; by Faisal Hoque, Thomas H. Davenport, Erik Nelson; 4/9/25Artificial intelligence is changing how humans and machines work together. But most organizations still focus on the technical aspect of AI implementation because their leadership structure does too. Companies need a new role, the chief innovation and transformation officer, to manage the profound cultural and organizational changes AI adoption brings. Here’s why forward-thinking organizations already have or plan to hire such leaders.

Lonely planet: How the world is fighting social isolation Medscape Medical News; by Deborah Brauser; 3/25/25 Loneliness/social isolation isn’t just a transient emotion or situation, it’s turned into a global crisis with serious public health consequences. In 2023, then–US Surgeon General Vivek Murthy, MD, sounded the alarm, declaring loneliness an epidemic and citing seminal research equating its harmful effects to smoking 15 cigarettes a day. The numbers tell a stark story: Recent research has linked chronic loneliness to depression, dementia, and even early death.Editor's note: Pair this with our recent post, Risk factors for and health status of socially isolated adults.

National Alliance for Care at Home responds to the FY 2026 Hospice Proposed Rule National Alliance for Care at Home, Alexandira, VA and Washington, DC; Press Release; 4/11/25 The National Alliance for Care at Home (the Alliance) issued the following statement [Fri 4/11] in response to the Centers for Medicare & Medicaid Services (CMS) Fiscal Year (FY) 2026 Hospice Wage Index proposed rule, which proposes payment and regulatory updates under the Medicare hospice benefit. The proposed 2.4% payment update fails to adequately address the mounting financial pressures facing hospices nationwide. With escalating operational costs driven by inflation, workforce shortages, and rising expenses for supplies and services, the proposed payment increase would threaten the ability of hospices to sustainably provide quality end-of-life care. “The proposed payment update for FY 2026 falls short of what is needed to sustain high-quality hospice care,” said Dr. Steve Landers, CEO of the Alliance. “Without meaningful adjustments, hospices across the country will face serious challenges—jeopardizing access to care for terminally ill patients and placing added strain on families already facing the unimaginable. ..."

Ahead of National Healthcare Decisions Day, aging and hospice expert urges Americans to commit to vital advance care and end-of-life conversationsNational Partnership for Healthcare and Hospice Innovation (NPHI) press release; by Tom Koutsoumpas; 4/10/25With National Healthcare Decisions Day next Wednesday, April 16, 2025, the National Partnership for Healthcare and Hospice Innovation (NPHI) is marking the occasion by encouraging Americans to use the day as an opportunity to have conversations with family or loved ones about steps they have—or have not—taken regarding their advance care and end-of-life plans. To help with conversations and prepare individuals to have the most effective discussion with their loved ones about these difficult topics, NPHI is also releasing its Five Point Guide below to show everyday Americans on how to have advance care planning conversations. [Points include:]

2026 Medicare Advantage and Part D rate announcementCMS press release; 4/7/25Today, the Centers for Medicare & Medicaid Services (CMS) released the Announcement of Calendar Year (CY) 2026 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (the CY 2026 Rate Announcement)... The final policies in the CY 2026 Rate Announcement are projected to result in an increase of 5.06%, or over $25 billion, in MA payments to plans in CY 2026.

Dr. Oz outlines vision for CMS: 8 notesBecker's Hospital Review; by Jakob Emerson; 4/10/25CMS Administrator Mehmet Oz, MD, said April 10 that his vision for the agency includes a commitment to President Trump’s “Make America Healthy Again” agenda and modernizing Medicare, Medicaid and the ACA marketplace. Eight notes: