Literature Review

Dying at home: A family guide for caregivingJohn Hopkins University Press; by Andrea Sankar with CM Cassady; 2/24A comprehensive guide for those caring for a loved one nearing the end of life. Many people seek the comfort and dignity of dying at home. Advances in pharmacology and hospice care allow the dying to remain at home relatively free of pain and symptoms, but navigating professional services, insurance coverage, and family dynamics often compounds the complexity of this process. Extensively updated and revised, this third edition of Andrea Sankar's Dying at Home: A Family Guide for Caregiving provides essential information that caregivers and dying persons need to navigate this journey.

High-cost cancer drug use in Medicare Advantage and Traditional MedicareJAMA Health Forum; Cathy J. Bradley, PhD; Rifei Liang, MA; Richard C. Lindrooth, PhD; Lindsay M. Sabik, PhD; Marcelo C. Perraillon, PhD; 1/25Traditional Medicare’s (TM) fee-for-service reimbursement encourages clinicians to provide higher-cost care, including prescribing expensive drugs when similar less expensive drugs are available. Medicare Advantage (MA) plans, where beneficiaries receive managed care almost exclusively from in-network hospitals and clinicians, were designed to reduce costs by paying a risk-adjusted capitated amount per member. In this cohort study of 4,240 patients with colorectal cancer (CRC) or non–small cell lung cancer (NSCLC), those with local or regional CRC who were insured by MA were less likely to receive a cancer drug, and of those patients, were less likely to receive a high-cost cancer drug than similar patients who were insured by TM. Patients diagnosed with distant NSCLC were less likely to receive a cancer drug if insured by MA compared to TM. MA appears to reduce high-cost drug utilization to treat patients with CRC, but not to treat those with NSCLC, in which few low-cost treatments exist.

FTC releases second interim staff report on prescription drug middlemen: Report finds PBMs charge significant markups for cancer, HIV, and other critical specialty generic drugsFTC press release; by FTC staff; 1/14/25Staff’s latest report found that the ‘Big 3 PBMs’—Caremark Rx, LLC (CVS), Express Scripts, Inc. (ESI), and OptumRx, Inc. (OptumRx)—marked up numerous specialty generic drugs dispensed at their affiliated pharmacies by thousands of percent, and many others by hundreds of percent. Such significant markups allowed the Big 3 PBMs and their affiliated specialty pharmacies to generate more than $7.3 billion in revenue from dispensing drugs in excess of the drugs’ estimated acquisition costs from 2017-2022. The Big 3 PBMs netted such significant revenues all while patient, employer, and other health care plan sponsor payments for drugs steadily increased annually, according to the staff report. Key Findings include:

Saturday newsletters focus on headlines and research - enjoy!

Virtual nursing could upend traditional staff ratiosBecker's Clinical Leadership; by Paige Twenter; 1/13/25In conversations about virtual, team-based nursing services, the term "nurse-to-patient ratios" is an anachronism, according to nursing leaders at Providence and Trinity Health. Within the traditional primary nursing model, a virtual mountain of research demonstrates low nurse-to-patient ratios bolster safety and quality of care. However, as new virtual programs emerge and pick up steam, new research indicates that virtual nursing models improve communication, safety and quality — all without assigning a ratio.

Policy priorities for the first 100 daysC-TAC press release; 1/20/25The first 100 days of the Trump Administration and 119th Congress offer a pivotal opportunity to enact bold policies that improve the quality of care for individuals with serious illness while reducing overall healthcare costs. By addressing key policy priorities, we can create a healthcare system that delivers better outcomes for patients and families. C-TAC calls on policymakers to act now to advance solutions in the following areas:

The HOPE Assessment Tool Series: Understanding the Required Timed VisitsCHAP blog; by Jennifer Kennedy; 1/25It’s January 2025, and we are counting down to the implementation of the HOPE Assessment Tool on October 1, 2025. That date may seem far away, but there is much preparation you need to do in the coming months for a seamless launch on the “go-date”. Your staff will need consistent education about the assessment tool content and their responsibility for the administration and completion of the timed visits. [Click the link above to read the entire story.]

Engaging the hospice community in end-of-life care in prisons (Part 2)ehospice; by Barry R. Ashpole; 1/21/25Part 1 offered a broad overview of the potential role community hospices can play to improve end-of-life care (EoLC) for a particularly vulnerable and underserved population. As has been widely acknowledged, prisons and correctional facilities are caught between the proverbial “rock and a hard place,” between issues of security and public safety and the civil rights of the prison inmates to healthcare comparable to what is available to the populace-at-large. Part 2 takes a closer look at specific initiatives by some community hospices to support prison inmates towards the end of life. Prior to conducting research for its 2020 report, ‘Dying Behind Bars: How can we better support people in prison at the end-of-life,’ Hospice UK had only anecdotal evidence of the important work that some hospices were engaged in to support prison inmates at the end of life. The scope of this support had not been established at a national level. After conducting a survey of hospice services across England, researchers found that 25 hospices – representing approximately 15% of hospices in the country – are indeed providing this care and support, working with 34 different prisons.Publisher's note: Also see: Engaging the hospice community in end-of-life care in prisons (Part 1) that was also discussed in Hospice News' Global challenges persist in bringing hospice care to incarcerated populations.

Barry Goldberg, blues-rock keyboardist whose work with Bob Dylan included controversial Newport '65 Concert, dies at 83 [with hospice care] Variety; by Chris Willman; 1/23/25 Barry Goldberg, a blues-rock keyboard player whose work with the Paul Butterfield Blues Band led to playing with Bob Dylan in the 1960s, including the notorious 1965 Newport Folk Festival concert dramatized in "A Complete Unknown," died Wednesday [1/23] at 83. Bob Merlis, a representative, said that Goldberg died in hospice care after a 10-year struggle with non-Hodgkin lymphoma, with his wife of 53 years, Gail Goldberg, and son, Aram, at his bedside.

Health policy at a crossroads: What to watch in 2025Health Affairs; by Katie Keith; 1/21/25This article is the first in a new Health Affairs Forefront featured topic, “Health Policy at a Crossroads.” Articles in this topic will offer timely analysis of prominent regulatory, legislative, and judicial developments in health policy... 2025 could mark a major inflection point in health policy. Over the past four years, among many other changes, the nation rebounded from a once-in-a-generation pandemic; the uninsured rate reached a record low—with record enrollment across Medicare, Medicaid, and the Affordable Care Act marketplaces; Medicare beneficiaries began to see savings on prescription drugs; overdose deaths dropped; and women lost the right to reproductive choice under the US Constitution, leading to abortion bans in more than 20 states less than three years since the Supreme Court overturned Roe v. Wade.

Healthcare Industry Team 2024 Year in Review JD Supra; by Claire Bass, S. Derek Bauer, Kevin Bradberry, Ernessa Brawley, Sarah Browning, Charlotte Combre, Payal Cramer, Emily Crosby, Vimala Devassy, Shareef Farag, Amy Fouts, Winston Kirton, Caroline Landt, Charlene McGinty, Justin Murphy, Lynn Sessions, Gregory Tanner; 1/22/25As we begin a year that will once again be transformative for the industry, we are excited to present our comprehensive 2024 year-in-review, highlighting all that has happened and the trends that will shape 2025. [Downloadable PDF from BakerHostetler, bakerlaw.com. Large categories include the following:]

Locally and veteran-owned Headwaters Hospice and Palliative Care expands healthcare offerings for Montana communities Business Post Examiner, Helena, MT; by Michael Brown; 1/22/25 In just one year since receiving the prestigious CHAP Accreditation, Headwaters Hospice and Palliative Care has become a cornerstone of compassionate care in the Helena Valley, Montana. ... Building on this success, Headwaters Hospice and Palliative Care is proud to announce its expansion into the Butte/Silver Bow County area, bringing its renowned services to even more Montanans. In addition to hospice care, the company will begin offering palliative care services in 2025. These services will not only provide an alternative provider for Helena but will also be the only in-home palliative care option available in Butte. 

Residents share video of Spring Grove Area guidance counselor, now in hospice after Jan. 1 collapse York Dispatch, York, PA; by Meredith Willse; 1/14/25 As news spread of a Spring Grove Area High School guidance counselor’s collapse after a run on Jan. 1, friends and former students shared a video she made — dancing in her office. Carrie Schmoyer collapsed Jan. 1 after a run. After being hospitalized for nearly two weeks, her family moved Schmoyer to a hospice center. The video, from the 2014-2015 school year, shows high schoolers and staff dancing in the hallways, offices, the auditorium and outside the school to “Happy” by Pharrell Williams. Among other school staff members, Schmoyer is seen dancing in her office. ... While sharing the video, the residents shared their memories of Schmoyer, how they loved her, how she helped them and the GoFundMe account, which has raised close to $50,000 since it started Jan. 6. Editor's note: This touching tribute reminds us that each person receiving hospice is connected to a much larger community of people who are impacted by this person's living and dying.