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. 

CMS halts spending for nonmedical in-home Medicaid services, likely affecting providers McKnights Home Care; by Adam Healy; 4/13/25 The Centers for Medicare & Medicaid Services told states last week that it would not approve future federal matching funds for designated state health programs (DSHPs) and designated state investment programs (DSIPs). These programs are widely used to help Medicaid beneficiaries remain at home and in their communities.

The modern health care professional: How to combine skills from different fields to redefine your career MedPage Today's KevinMD.com; by Jalene Jacob, MD, MBA; 4/11/25 Gone are the days when careers followed linear paths and job titles neatly fit into predefined boxes. Today’s health care industry celebrates versatility, and hybrid professionals are redefining what it means to succeed. A hybrid health care professional combines skills and expertise from different fields, blending knowledge to create unique value in the health care space. Whether you’re a nurse with coding skills, a doctor with a passion for data analysis and research, or a biomedical engineer with a talent for design and business, hybridization is becoming the new competitive advantage. This article explores how early professionals can harness their diverse interests and talents to shape their careers and stand out in a rapidly evolving job market.

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]

Health systems spend millions to reduce workplace violence Modern Healthcare; by Caroline Hudson; 4/14/25 Health systems are spending millions of dollars ramping up security measures at their facilities to protect patients and staff. Many systems are hiring more officers, implementing weapons detection screenings and updating communication protocols. Executives said these efforts are a response to an uptick in workplace violence over the past several years, ranging from assaults on staff members to sexually aggressive comments and shootings. ... [A] 2022 report from the Online Journal of Issues in Nursing said workplace violence costs the U.S. approximately $151 billion per year, with most incidents occurring in healthcare and social services.

One of Deserae Turner’s last wishes comes true as family, friends hold small horse show in her honor ABC-4 KTVX, Cache Valley, UT; by Trevor Myers; 4/12/25 For six years, Deserae Turner rode horses and competed in shows alongside her siblings. In 2017, things changed after Deserae was shot in the head and began her journey of recovery. ... Deserae and her family had not been to another horse show since she was shot — that is, until Saturday, April 12. After a recent health complication, Deserae decided to enter hospice care, and one of her last wishes was to ride a horse and see a horse show again.

DOJ’s lawsuit against Amedisys, UnitedHealth Group set for mediation Hospice News; by Jim Parker; 4/14/25 The U.S. Department of Justice’s (DOJ) lawsuit against Amedisys Inc. (NASDAQ: AMED) and UnitedHealth Group (NYSE: UNH) will go to mediation on Aug. 18. The DOJ sued the two companies starting in November of last year to block the UnitedHealth Group subsidiary Optum from acquiring Amedisys due to antitrust concerns. The case will now go to a mediation conference before a magistrate judge. ... DOJ’s chief concern is that the combination of the two companies would dampen competition in the hospice and home health space. Should the transaction proceed, Optum would control 30% or more of the home health or hospice services in eight states, according to the complaint. 

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.

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:

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

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. ..."

Karen Rubel of Nathan Adelson Hospice announces transition to President of Chapters Health West; Lori Townsend named as new Executive Director of the Las Vegas-based nonprofit hospice Nevada Business; by Nathan Adelson Hospice; 4/11/25 Nathan Adelson Hospice, the leader in hospice and palliative care in southern Nevada, and its Board of Trustees announced today that President and CEO Karen Rubel has transitioned to become President of Chapters Health West, a newly launched division of Chapters Health System. As her new role gets underway, Nathan Adelson Hospice’s current Chief Nursing Officer Lori Townsend has been promoted to Executive Director of Nathan Adelson Hospice.

Defining palliative care quality in murky regulatory watersPalliative Care News; by Holly Vossel; 4/4/25The wide range of palliative care services available nationwide can present obstacles around consistent quality measurement. Calls are growing louder for a federally established set of standardized palliative guidelines.Notable mentions: Monisha Pujari, Longleaf Hospice & Palliative Care; Yonah Klein, Unity Hospice and Palliative Care; Keith Everett, ProCare Hospice / TruHue consulting.