Literature Review

Alliance Statement on House passage of Reconciliation Bill: Medicaid provisions threaten home and community-based services for millions of vulnerable Americans National Alliance for Care at Home, Alexandira, VA and Washington DC; Press Release; 7/3/25 The National Alliance for Care at Home (the Alliance) issued the following statement today in response to the House’s passage of the “One Big Beautiful Bill Act,” also known as the Reconciliation bill, which now heads to President Trump’s desk for his signature. “The Alliance is deeply troubled by the Medicaid provisions within the One Big Beautiful Bill Act, which has passed both chambers of Congress and now awaits President Trump’s signature,” said Alliance CEO Dr. Steve Landers. “These provisions—including work requirements, reduced provider taxes, and new cost-sharing mandates—prioritize short-sighted budget savings over the health and wellbeing of our most vulnerable citizens who rely on home and community-based services (HCBS).”

Sunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!

I bet jellyfish are sad that there are no peanut butter fish.

Palliative care education in pediatric cardiology fellowships: A survey of program directorsPediatric Cardiology; Lesje DeRose, Sarah Godfrey, Shabnam Peyvandi, Nicole M. Cresalia, Jill M. Steiner, Emily Morell; 6/25 Our survey demonstrated a wide range of PC [palliative care] educational practices among categorical pediatric cardiology fellowship programs. While most programs provided some form of PC education to their fellows, the amount and modality varied widely between programs, from very minimal PC exposure to required core PC rotations. Almost half of the participating PDs [program directors] reported dissatisfaction with the current amount of PC education in their fellowship programs. Programs such as VitalTalk (www.vitaltalk.org) and other (both in-person or virtual) modules have been utilized in other training environments with improvement in trainee comfort in PC topics, including CardioTalk for adult cardiology trainees. Didactic-based curricula in PC topics, such as mental health and ethics, have also been shown to help providers gain confidence in PC domains.

Health economic analysis of an all-virtual, at-home acute care modelJAMA Network Open; Brad Spellberg, MD; Christopher Lynch, MD; Hal F. Yee, MD, PhD; Josh Banerjee, MD; 6/25Hospital-at-home care models send staff, durable medical equipment (DME), and therapeutics (eg, intravenous infusions) to patients’ homes to provide care. In the US, Medicare requires in-person evaluations at least twice daily to receive payment for hospital-at-home services. In the UK National Health Service, virtual wards at home are increasingly being used in lieu of inpatient care. This economic evaluation of ... patients receiving all-virtual, at-home acute care ... found that the virtual program was cost-saving (due to avoided variable hospital costs) only for unfunded patients or patients with Medicaid, but was cost-losing for Medicare and commercially insured patients due to substantial lost inpatient revenue. These findings suggest that current payer rates for inpatient care financially disincentivize development and implementation of novel acute, at-home care models, but a simple reimbursement schema could enable net savings to both hospitals and payers.

Impact of spirituality in Christians with serious illness - A phenomenological studyAmerican Journal of Hospice and Pallaitive Care; Judy Lentz; 6/25Seeking support within the faith community is frequently noted in Christians with serious illness. Research interviews captured four major structures with accompanying constituent parts [including] ... sovereignty of God with unpredictability, relationship with God especially through prayer, illness-related loss with accompanying guilt for the subsequent burden created for the caregivers, and gratitude for the love and support shown to the participant by loved ones and others. The impact of the structures and constituent parts of spirituality identified by the Christians who participated in this study demonstrates the value and significance of the faith-based spiritual support received during their illness.

Hospice and palliative care experiences as expressed on the r/hospice and r/palliative subredditsAmerican Journal of Hospice & Palliative Medicine; Riley Shin, BSA; Ashley Shin, MD; Elizabeth K. Nugent, MD, MS; 6/25 Reddit, an anonymous online community forum, provides space for sharing medical information, seeking emotional support, and facilitating open communication. This qualitative study examined the most popular questions on the r/hospice and r/palliative communities on Reddit. Seven primary themes emerged from question and advice-seeking r/hospice comments: (1) the dying process (24%), (2) coping and emotional support for patients and caregivers (22%), (3) logistics of hospice and palliative care (22%), (4) medication treatments and side effects (13%), (5) negative hospice experiences (10%), (6) support for hospice providers (7%), and (7) other less related material (2%). Assessment of posts on the r/hospice and r/palliative subreddits revealed gaps in communication between patients, caregivers, and healthcare providers in several important areas, most importantly in demystifying the dying process and providing patient and caregiver support.

Measuring goal-concordant care using electronic clinical notesJAMA Network; by Catherine L. Auriemma, Anne Song, Lake Walsh, Jason Han, Sophia Yapalater, Alexander Bain, Lindsay Haines, Stefania Scott, Casey Whitman, Stephanie Parks Taylor, Gary E. Weissman, Matthew J. Gonzales, Roshanthi Weerasinghe, Staci J. Wendt, Katherine R. Courtright; 7/3/25In this longitudinal cohort study among 109 patients with serious illness and limited prognoses, clinicians reviewed and classified 398 epochs of care as goal concordant (50%), goal discordant (19%), or of uncertain concordance (32%) with nearly perfect interrater agreement for categorizing the type of care received. These findings suggest that using electronic clinical notes to measure goal-concordant care is feasible, laying the groundwork for future automated text-based classification methods to improve reliability and pragmatism of measuring goal-concordant care for clinical and research use at scale.

Home-based palliative care for cancer patients: Evaluating a decade of nursing-led interventionsAmerican Journal of Hospice and Palliative Medicine; Júnia de Oliveira Alves, RN; Eduardo Bruera, MD; Mônica Isaura Corrêa, MD; Sonia Souza, PhD; Marília Ávila de Freitas Aguiar, PhD; Ana Paula Drummond-Lage, PhD; 6/25Home-based palliative care is an effective approach for managing advanced-stage cancer patients, particularly in regions with limited healthcare infrastructure. In Brazil, the “Better at Home” Program enables interdisciplinary teams to deliver palliative care in patients’ homes, with nurses playing a central role in providing clinical and supportive interventions. Registered nurses (RNs) were responsible for complex procedures, supervision of nursing technicians (NTs), and caregiver training, while NTs performed routine clinical tasks and assisted with daily care. Notably, 99.4% of patients died at home, suggesting alignment with palliative goals of care. These findings underscore the central role of RNs in coordinating and delivering home-based palliative oncology care within a multidisciplinary framework.

Social Media Watch 7/11/25

New Winship web tool helps Georgians find palliative care services Emory University Winship Cancer Institute; Press Release; 7/7/25 Patients, families and referring physicians now have a new online source for locating palliative care services in Georgia. Developed by Winship Cancer Institute of Emory University, More Access to Palliative Care Georgia (MAPGA) is a searchable database of vetted inpatient and outpatient palliative care agencies and hospital-based programs across the state. ... Users who visit MAPGA can view a list and interactive map of nearby palliative care services, including hospital-based outpatient clinics and home-based care. For more customized results, they can enter their zip code or filter by location (clinic, in-home or hospital-based/inpatient) and type (adult or pediatric). MAPGA also features a “heat map” that highlights gaps in access to care. 

HPCC strengthens commitment to DEIB across credentialing programs Hospice & Palliative Nurses Association / Foundation / Credentialing Center (HPNA/HPNF/HPCC); Press Release; 7/10/25 In 2025, the Hospice and Palliative Credentialing Center (HPCC) has continued its implementation of strategic initiatives that advance diversity, equity, inclusion, and belonging (DEIB) across its credentialing programs. From in-depth exam item reviews to national outreach and inclusive resource development, HPCC remains committed to ensuring fairness and inclusivity in all certification processes. The following strategic initiatives reflect the progress HPCC has made and showcase the future direction of its DEIB efforts. ... This work is part of HPCC’s broader goal to strengthen the inclusivity of its credentialing programs. As HPCC explores the expansion of DIF analyses across additional certification exams, the organization remains rooted in its mission.

Texas flooding: Live updates and main donation linkLinks below are from CNN and the Community Foundation of the Texas Hill Country