Literature Review

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

Health care in the USA: money has become the missionThe Lancet; by Adam Gaffney, Steffie Woolhandler, David U Himmelstein, Danny McCormick; 10/21/25Despite extraordinary scientific and medical resources, the US health-care system underperforms. In this Review we consider the damage wrought by decades of market-based policies that have stimulated profit-seeking by insurers and health-care providers.

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.

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?

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.

How Optum’s Amedisys deal could shake up the hospice marketHospice News; by Jim Parker; 10/21/25The acquisition of the home health and hospice provider Amedisys by the insurance mammoth UnitedHealth Group (NYSE: UNH) has far-reaching implications for the hospice community. The UnitedHealth Group subsidiary Optum, in June 2023 inked its agreement to acquire Amedisys in an all-cash transaction of $101 per share, or about $3.3 billion. After leaping a series of regulatory hurdles, including a U.S. Justice Department lawsuit, the deal closed in mid-August... The merger likely makes UnitedHealth Group one of the largest hospice providers in the United States.

Raising the bar in healthcare leadership trainingUConn Today; by Barbara O’Neill; 10/21/25“Clinical leadership training is vital to launching the next generation of our health care workforce,” says Raquel Manley, DMD, faculty and alum of the Urban Service Track/AHEC Scholars (UST/AS) Program, located on the UConn Health campus in Farmington. “Effective health care is based upon clear communication, conflict resolution, and teamwork for the health and well-being of our patients and community members. In my experience as an Urban Health/AHEC Scholar, coach, and faculty, I have found that today’s students are often very brilliant academically and in social settings but need coaching and counseling on leadership skills once they enter the workforce.” So why is this the case?

Why the infusion market is shifting to at-home care Modern Healthcare; by Diane Eastabrook; 10/21/25Key Takeaways

GeriPal Live! at NPCRC Foley Retreat: Dio Kavalieratos, Prasanna Ananth, Alexi WrightGeriPal podcast; by Eric Widera, Alex Smith, Dio Kavalieratos, Prasanna Ananth, Alexi Wright; 10/16/25Today we join you from beautiful Banff, Alberta, Canada at the National Palliative Care Research Center (NPCRC) annual Kathleen Foley retreat... On today’s podcast, we invited Dio Kavalieratos, Prasanna Ananth, and Alexi Wright to join us to talk about three articles that spoke to them. Prasanna chose an article by Abby Rosenberg about being fired in palliative care... Dio chose an article about the economic benefits of palliative care internationally, a call to action... Alexi chose an article about cancer care in prison.

How to talk to your loved ones about end of life wishes Those Nerdy Girls; by Rebecca Raskin-Wish; 10/17/25 It’s important to have discussions about what you want the end of your time on earth to look like and have a healthcare proxy and an advance directive in place. When my sister and I were teenagers, my mom sat us down, and in a potentially more dramatic fashion than the moment called for, she said, “Girls, my death could happen any moment, and we need to talk about it.” ...