Literature Review

How physician CEOs are reenergizing later-career cliniciansBecker's Hospital Review; by Kristin Kuchno; 4/9/25 While much attention has been paid to recruiting top talent amid workforce shortages, retaining physicians later in their careers is also a key focus for health systems. Mentorship, flexible scheduling and leadership development opportunities can help energize experienced physicians and reduce burnout in the years leading up to their retirement, health system CEOs told Becker’s. Physician CEOs are uniquely positioned to understand the challenges around burnout and retention. Sunny Eappen, MD, president and CEO of The University of Vermont Health Network in Burlington [described], “Having experience being in front of a patient and having to either have difficult conversations or make difficult decisions is at the core of what we do,” Dr. Eappen said. “People understand that I can really speak from the heart and truly be in their shoes.”

‘Medical aid in dying’ bill passes Nevada Assembly despite Lombardo veto threat Las Vegas Review-Journal; by McKenna Ross; 4/17/25 An effort to legalize medical aid in dying for terminally ill people has passed a crucial vote Thursday despite Gov. Joe Lombardo’s threat to veto the measure. Assembly Bill 346 would create a legal framework for competent and willing terminally ill patients to self-administer life-ending medicines. It passed in the Assembly on Thursday, 23-19.

3 major tactics used by hospice scammers Hospice News; by Jim Parker; 4/18/25 Among the numerous tactics that unscrupulous hospices use to commit fraud, three are rising to the forefront. Four states have garnered national attention as fraud hotbeds — Arizona, California, Nevada and Texas. These regions have seen swarms of new hospices emerging and receiving Medicare dollars. Numerous reports of unethical or illegal practices have surfaced, particularly among these new companies. ... One common practice among them is to keep their patient census low to avoid regulators’ attention, Judy Lund Person, principal of the consulting firm Lund Person and Associates, ... Among these providers, three principal tactics are emerging, according to Sheila Clark, president and CEO of the California Hospice and Palliative Care Association. ...

What's at stake if CDC's Infection Control Practices Committee is cut MedPage Today; by Alexander Sundermann, DrPH; 4/17/25 Whether you are placing a central line, managing a Clostridioides difficile case, or keeping a surgical field sterile, you're likely following standards influenced by the Healthcare Infection Control Practices Advisory Committee (HICPAC). While it may not be widely known outside of infection prevention circles, HICPAC plays a central role in shaping the evidence-based guidelines that frontline clinicians use every day to protect both patients and healthcare workers. ... Frontline clinicians ... rely on HICPAC guidance every day. Its recommendations shape the protocols used to prevent device-related infections, respond to emerging outbreaks, and meet regulatory and accreditation requirements. ...Eliminating HICPAC wouldn't just slow progress -- it would erode the foundation of infection prevention in U.S. healthcare.

National Volunteer Week: April 20-26, 2025

RCT of PC in EDGeriPal podcast; by Eric Widera, Alex Smith, Corita Grudzen, Fernanda Bellolio, Tammie Quest; 4/10/25Today we focus on an intervention, published in JAMA, that gave emergency clinicians basic palliative care knowledge, training, and skills. We talk with Corita Grudzen and Fernanda Bellolio about their cluster stepped wedge randomized trial of a palliative care intervention directed at emergency clinicians... We are fortunate to have Tammie Quest, emergency and palliative trained and long a leader in this space, to help us unpack and contextualize these findings.

Rural US loses 43% of independent physicians: 5 things to know Becker's Hospital Review; by Kelly Gooch; 4/7/25 The number of independent physicians in U.S. rural areas declined 43% over five years — from 21,956 in January 2019 to 12,467 in January 2024 — according to an Avalere study sponsored by the Physicians Advocacy Institute. ... Five things to know:

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. ..."

Social Media Watch 4/11/25

Ahead of National Volunteer Week and in celebration of National Volunteer Month, NPHI CEO urges Americans: “Step forward. Be present. Volunteer with your local hospice.” National Partnership for Healthcare and Hospice Innovation (NPHI), Washington, DC; by Matt Wilkinson; 4/16/25 Ahead of National Volunteer Week next week [April 20-26], and in celebration of National Volunteer Month this April, the National Partnership for Healthcare and Hospice Innovation (NPHI) is shining a light on the often-unsung heroes of hospice: volunteers. These compassionate individuals are central to the mission of NPHI’s member providers nationwide, offering their time, energy, and hearts to patients and families during life’s most tender and vulnerable moments. NPHI member organizations rely on nearly 30,000 volunteers to keep their programs running—almost matching the number of full- and part-time staff employed across its national member network. Nationwide, hundreds of thousands of hospice volunteers contribute millions of hours of service annually. This deep tradition of volunteerism isn’t just symbolic—it’s built into the very structure of hospice care. All Medicare-certified hospices are required to have volunteers actively involved in patient and family support, reflecting the core values of compassion and community care that define the field.Editor's note: Throughout the year, find this and more national observances on our newsletters "Healthcare Observances" tab at the top of our website, https://www.hospicepalliativecaretoday.com/resources/healthcare-observances.

Faith is the strength by which a shattered world shall emerge into the light. ~ Helen Keller

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

Advance care planning in the inpatient setting: The role of the hospitalistAmerican Journal of Hospice and Palliative Medicine; Nikhil Sood, MD; Rohini Garg, MBBS; Anthony D. Slonim, MD, DrPH, FCCM; 3/25Advance care planning (ACP) is critical to patient-centered health care, particularly in hospital settings where acute and end-of-life decisions often occur. As frontline providers, hospitalists are uniquely positioned to initiate and guide ACP discussions. This article explores the role of hospitalists in ACP, identifies barriers to its implementation, and highlights strategies to overcome these challenges. Key barriers include time constraints, lack of formal training, and uncertainty regarding the appropriate timing of discussions. To address these issues, hospitalists can benefit from structured communication training, integration of ACP prompts into electronic health records, and collaboration with multidisciplinary teams. While ACP has demonstrated benefits, including the alignment of care with patient preferences, reduced unnecessary interventions, and improved satisfaction for patients and families, challenges remain in ensuring consistent and culturally sensitive implementation.