Literature Review

BoldAge CMO Glenn Meyers: PACE is palliative care Hospice News; by Jim Parker; 8/19/24 Palliative care is integral to Programs for All-Inclusive Care of the Elderly (PACE) programs, according to Dr. Glenn Meyers, who was recently promoted to chief medical officer of BoldAge PACE. New Jersey-headquartered BoldAge emerged last year, established by a group of former hospice and home health leaders. The company currently operates four PACE centers located in the Northwest and the Midwest, with two more slated to open before the end of the year. Ultimately, BoldAge PACE plans to build a national footprint.

Hospice CARE Act would create reimbursement for high-acuity hospice services Hospice News; by Holly Vossel; 8/19/24 If enacted, the Hospice Care Accountability, Reform and Enforcement (Hospice CARE) Act could open up reimbursement pathways for high-acuity palliative services during a time when demand and costs are rising. Developed by U.S. Rep. Earl Blumenaur (D-Oregon) and announced in June at the Hospice News Elevate conference, the bill proposed massive reimbursement and regulatory changes to the Medicare Hospice Benefit. Currently in a discussion draft phase, the bill includes ways for hospice providers to have clearer definitions and improved payment for more intensive forms of palliation, such as radiation therapy, blood transfusions or dialysis, among others.

Integration of palliative pharmacists to elevate oncologic care Pharmacy Times; by Alexis Beachy, PharmD and Jessica Geiger, PharmD, MS, BCPS; 8/20/24... Conclusion: This case demonstrates several aspects of care palliative pharmacists can assist with, though it is certainly not all-encompassing. All things considered, pharmacists are an essential asset of the palliative team. Their experience further enriches the interdisciplinary team and grants all patients and families many benefits. Specifically, patients receiving oncologic care benefit from collaboration with a palliative care pharmacist. In addition to offering a more individualized and holistic approach to care, palliative pharmacists can also provide patients with quicker and improved symptom management, which often improves quality of life and may also increase survival rates.Editor's Note: This article provides excellent history, definitions, and descriptions of the pharmacist's significant role in providing expert palliative and hospice care.

​​Bioethicists scrutinize Pontifical Academy for Life’s new guidance on withdrawing food, water The Catholic World Report; by Jonah McKeown; 8/16/24 After the Pontifical Academy for Life (PAFL) last month issued a booklet summarizing the Church’s teaching on a number of bioethical issues, the section on “artificial nutrition and hydration” (ANH) has some observers concerned about what they see as a departure from previous Church teaching. ... The Church’s teaching on this issue was recently in the news in the United States because of the ongoing case of Margo Naranjo, a disabled Texas woman whose parents, who are Catholic, announced last month that they had decided to allow Margo to die by starvation in hospice. They were prevented from doing so after a judge intervened. ... What does the Pontifical Academy's new document say? ... “[T]he doctor is required to respect the will of the patient who refuses them with a conscious and informed decision, also expressed in advance in anticipation of the possible loss of the ability to express himself and choose,” the PAFL wrote. he PAFL noted that Pope Francis has emphasized the importance of considering the whole person, not just individual bodily functions, when making medical decisions.Editor's Note: This "guidance" and discussion is much more complex than the summarized information above. Click on the title's link to read more.

Nationwide home healthcare and hospice provider to pay $3.85M to resolve False Claims Act allegationsDepartment of Justice press release; 8/20/24Intrepid U.S.A. Inc., headquartered in Dallas, and various wholly-owned subsidiaries (Intrepid) have agreed to pay $3,850,000 to resolve allegations that Intrepid violated the False Claims Act in connection with two lines of its business: first, that Intrepid knowingly submitted claims to Medicare for home healthcare services for patients who did not qualify for the Medicare home healthcare benefit or where services otherwise did not qualify for Medicare reimbursement; and second, that Intrepid knowingly submitted claims to Medicare for patients who did not qualify for the hospice benefit. The settlement is based on Intrepid’s ability to pay.

The dangers of healthcare generative AI 'drift' Becker's Health IT; by Giles Bruce; 8/15/24 IT leaders are embracing generative AI in healthcare but also expressing concerns that the technology can "drift." The performance of GPT-4, the large language model that powers ChatGPT, in answering healthcare questions can change over time, a phenomenon known as "drift," according to a study by researchers at Somerville, Mass.-based Mass General Brigham. Their work was published Aug. 8 in NEJM AI. "Generative AI performed relatively well, but more improvement is needed for most use cases," said corresponding author Sandy Aronson, executive director of IT and AI solutions at Mass General Brigham Personalized Medicine, in an Aug. 13 statement. "However, as we ran our tests repeatedly, we observed a phenomenon we deemed important: running the same test dataset repeatedly produced different results." ... The variability of the results could differ across days, so the authors say the AI's performance needs to be continuously monitored. 

New York State Department of Health Launches Center for Hospice and Palliative Care New York State Department of Health; Press Release; 8/19/24 The New York State Department of Health today announced the new Center for Hospice and Palliative Care, which will be under the Department's Office for Aging and Long Term Care (OALTC). The new Center, established under the leadership of Governor Kathy Hochul, will be led by Kara Travis, a health care executive who most recently served as Chief Executive Officer of Mountain Valley Hospice and Palliative Care in Gloversville, New York. "This new center will help us remove barriers that impact access to the profound comfort, support and dignity that palliative and hospice services can provide for individuals and families facing the end of life," State Health Commissioner Dr. James McDonald said. "Launching the Center for Hospice and Palliative Care was a top priority for this Department and highlights Governor Hochul's ongoing commitment to eliminating healthcare disparities for all New Yorkers."

Hospice physician’s convictions and $15 million in restitution affirmed for ‘pervasive’ fraud CCH Incorporated; by Justin Marcus Smith, J.D.; 8/15/24 The Fifth Circuit found it circumstantially telling that the jurors saw multiple hospice patients testifying at trial nearly a decade after the convicted physician had recommended them for end of life care. In an unpublished opinion, the United States Court of Appeals for the Fifth Circuit affirmed a physician’s conviction for conspiracy to commit health care fraud and for seven individual counts of healthcare fraud in connection with hospice care service recommendations. Applying de novo review, the court affirmed the convictions on the basis that the government presented enough circumstantial evidence, without direct evidence of intent, for a reasonable jury to have found guilt. With respect to sentencing, the circumstances surrounding 7,000 hospice claims formed a basis for fraud so pervasive that the government did not need to “sift” through each of the claims.

Honest conversations and cherishing the day: Leadership advice from oncology leaders Becker's Hospital Review; by Elizabeth Gregerson; 8/16/24 Leaders from two of the top five cancer centers, as ranked by U.S. News & World Report, shared with Becker's the best leadership advice they have received. ...

HCA pushed out providers, downgraded care after acquiring Mission Health: report Healthcare Dive; by Susanna Vogel; 8/16/24 Dive Brief:

Why Optum thrives where other companies failed Becker's ASC Review; by Patsy Newitt; 8/16/24 UnitedHealth Group's Optum, parent company of Deerfield, Ill.-based ASC chain SCA Health, has seen massive growth in the last few years as other big healthcare networks face obstacles in reaching large-scale profitability. ... A key to Optum's success is its affiliation with a large insurance business. The Journal pointed to the "several financial incentives for an insurer to own a health provider, including that it pays itself." ... And Optum keeps growing. The company spent $31 billion on acquisitions in the last two years, The Oregonian reported May 13. ... UnitedHealth Group is facing scrutiny regarding the Change Healthcare ransomware attack in February. The attack delayed payment and claims processing for healthcare providers around the country, as UnitedHealth subsidiary Change Healthcare handles an estimated one in three healthcare transactions.

A friend until the end: The impact of hospice volunteers Parkview Health, Fort Wayne, IN; 8/16/24 The presence of a hospice volunteer offers a unique form of support that complements the effots of a care team consisting of physicians, nurses, social workers and chaplains. While these specialists focus on a patient's physical, logistical and spiritual needs, volunteers contribute the element companionship during an emotionally difficult time. Jane Sandor, retired schoolteacher and principal, and Sally Stuckway, former executive director of a medical practice in Lafayette, IN, share how their personal experiences with hospice care shaped their desire to give back.

Bereaved parent preferences on quality end-of-life care for children with cancer in the South Cancer - American Cancer Society; by Isaac Martinez BA, Erin Currie PhD, RN, Elizabeth S. Davis MS, Rohail Kumar MD, Valerie Lawhon MS, ALC, NCC, Jennifer M. Snaman MD, Raba B. Tefera BA, Smita Bhatia MD, MPH, Abby R. Rosenberg MD, MS, MA, Emily E. Johnston MD, MS; 8/18/24 The authors sought to understand bereaved family preferences for end-of-life (EOL) care, particularly among Black families and those in the South. ... Family decision-making involved maintaining hope, not causing harm, doing what was best for their child and themselves, and religious beliefs. There was no clear preference for home versus hospital death (3.0 [1.8–4.0]). Instead, parents considered their child’s desires and/or medical needs, siblings, and prior experiences with death. To have a comfortable death, parents highlighted the need for comprehensive education about their child’s EOL, a caring and comfortable environment, and 24/7 access to their care team. Families expressed a dual preference for comfort care ... and chemotherapy ... at EOL.