Literature Review

The best revenge is not to be like your enemy. ~Marcus Aurelius

Veterans with burdened caregivers more likely to enter nursing homes, study findsMcKnight's Home Care; by Foster Stubbs; 9/30/25Veterans whose family caregivers reported higher emotional burden and depression were more likely to be admitted to nursing homes after three-year follow-ups, according to a September study published in the Journal of the American Geriatrics Society.Publisher's note: Perhaps higher emotional burden and depression among family caregivers of veterans occurs in hospice, too.

The best, worst states for Medicare: ReportBecker's Payer Issues; by Elizabeth Casolo; 10/16/25Vermont, Utah and Minnesota topped the Commonwealth Fund’s Medicare performance scorecard in 2025, whereas Kentucky, Mississippi and Louisiana struggled the most. The healthcare research foundation evaluated states on criteria spanning four domains: access to care, quality of care, costs and affordability, and population health. These performance indicators draw from CMS, federal surveys and other public data sources. The Commonwealth Fund ranked states according to how well Medicare was working based on those indicators. The organization mostly reviewed data from 2023 through 2025.

Rethinking slow codes: Gina Piscitello, Parker Crutchfield, Jason WassermanGeriPal podcast; by Eric Widera, Alex Smith, Gina Piscitello, Parker Crutchfield, Jason Wasserman; 10/23/25I’m going to begin with a wonderful quote from a recent editorial in Bioethics by our guests Parker Crutchfield & Jason Wasserman. This quote illustrates the tension between the widely held view in bioethics that slow codes are unethical, and the complexity of real world hospital practice: “Decisive moral positions are easy to come by when sitting in the cheap seats of academic journals, but a troubling ambivalence is naturally characteristic of live dilemmas.” ... Today we talk about what constitutes a slow code, short code, show code, and “Hollywood code.” We talk about walk don’t run, shallow compressions, and…injecting the epi into the mattress! We explore the arguments for and against slow codes: harm to families, harm to patients, moral distress for doctors and nurses; deceit, trust, and communication; do outcomes (e.g. family feels code was attempted) matter more than values (e.g. never lie or withhold information from family)? ... One thing we can all agree about: the ethics of slow codes need a rethink.

Executive Personnel Changes - 10/24/25

Hospice exec evaluates possible ‘path forward’ for MA hospice carve-inMcKnight's Newsmakers Podcast; by Liza Berger, Joe Shega; 10/15/25The so-called “carve-in” failed when the Centers for Medicare & Medicaid Services halted the hospice portion of the Value-Based Insurance Design program last year. And just last month, providers were speaking out against the carve-in to lawmakers at the annual fly-in for the National Alliance for Care at Home. But the two value-based care programs — hospice and MA — are not necessarily incompatible, according to Joe Shega, MD, chief medical officer for hospice provider VITAS Healthcare. As long as all the stakeholders agree about the parameters — that benefits remain intact, that there is no delay in access — there can be a “path forward” for hospice to be part of the MA benefit, he told McKnight’s Home Care in a Newsmakers podcast.

55% of healthcare executives plan to change roles within 3 years: SurveyBecker's Hospital Review; by Kristin Kuchno; 10/17/25More than half of healthcare executives plan to leave their roles within the next three years, according to a report from LHH, an executive search firm. Here are six more things to know from two 2025 surveys...

Providence, Humana partner on data exchange for value-based careBecker's IT Health; by Giles Bruce; 10/20/25Renton, Wash.-based Providence and Humana are collaborating on a new data exchange model to boost value-based care. The 51-hospital system and payer giant say they plan to go live in October with automated member attribution for Humana Medicare Advantage members before expanding into other data exchange functions to reduce administrative burden and elevate clinical decision-making. They hope their efforts will serve as models for providers and payers across the country.Publisher's note: An interesting model for partnering on data exchange. How might hospices pursue similar collaborations?

When a person can’t find a deep sense of meaning, they distract themselves with pleasure. ~Viktor Frankl

CAPC and the National Kidney Foundation partner on The Case for Palliative Care in Kidney CareCAPC blog; 10/8/25New publication underscores how palliative care can improve outcomes for patients with advanced kidney disease. The CAPC and the National Kidney Foundation (NKF) have released a new publication, The Case for Palliative Care in Kidney Care, which emphasizes the critical need to integrate palliative care services into the treatment of patients with advanced kidney disease.

Hospital - and private equity – affiliated specialty physicians negotiate higher prices than independent physiciansHealth Affairs; by Alexander P. Philips, Nandita Radhakrishnan, Christopher M. Whaley, Yashaswini Singh; 10/25Hospital and private equity (PE) consolidation in health care is altering the physician practice landscape, with more than three-quarters of physicians employed by these corporate entities as of 2023. We examined practice affiliation patterns for specialist physicians and those patterns’ association with commercial prices for cardiology and gastroenterology services... Hospital-affiliated specialists negotiated prices that were 16.3 percent higher for cardiology procedures and 20.7 percent higher for gastroenterology procedures compared with specialists in independent practices. PE-affiliated specialists negotiated prices that were 6.0 percent higher for cardiology and 10.0 percent higher for gastroenterology procedures.

Teaching end-of-life care: Q&A with professor of medicine Medical Xpress; by Mahima Samraik, Yale University, edited by Sadie Harley; 10/20/25 Every year, thousands of families sit in hospital rooms hearing words no one wants to hear: "We have done everything we can." What happens next, whether doctors stay engaged or step away, can transform one of life's most difficult moments for patients and their families. Unfortunately, for too many patients, the shift from curative care to end-of-life care leaves them feeling stranded. ... "But it doesn't have to be this way," says Matthew Ellman, MD, professor of medicine (general medicine) at Yale School of Medicine (YSM) and director of Medical Student Palliative and End-of-Life Care Education. Ellman has spent decades at patients' bedsides and now teaches medical students about death and dying. In his recent essay in Academic Medicine, he draws from his personal experiences as a physician and encourages fellow doctors to embrace difficult conversations around end-of-life care.