Literature Review

Optum’s home-based care arm propelling growth at UnitedHealth Group Hospice News; by Jim Parker; 10/15/24 UnitedHealth Group’s subsidiary OptumHealth is a growth engine for the massive health care and insurance company. In addition to other services OptumHealth holds a substantial home health and hospice business. Optum is in the process of acquiring the home health and hospice provider Amedisys (NASDAQ: AMED), with closing expected before the end of the year, pending some regulatory hurdles. Optum last June penned its agreement to acquire Amedisys in an all-cash transaction of $101 per share, or about $3.3 billion. The Amedisys deal is among a slew of large acquisitions by Optum, which include the home health and hospice provider LHC Group and the health care tech company Change Healthcare. Optum closed its $5.4 billion acquisition of LHC Group in February 2023. 

AI and change management: Navigating the human side of AI Method; by Jaon Rome; 10/14/24 ... An effective AI change management strategy must consider multiple employee groups — including front-, middle-, and back-office workers — whom AI implementation most affects. How you talk about AI and introduce AI tools to your employees influences how your people perceive AI, which affects their acceptance and adoption of it. ... Your AI investments’ success depends on your people. They must buy into AI’s value, see themselves as innovating with AI rather than training their replacements, and use the AI tools you’ve built in their day-to-day work.

Managing the hospice payment cap by balancing Length of Stay Hospice News; by Jim Parker; 10/15/24 Careful management of the hospice aggregate cap is key to providers’ sustainability as regulatory scrutiny continues to heat up. The cap is designed to prevent overuse of hospice, put controls on Medicare spending and foster greater access to care among patients. For Fiscal Year 2024, the U.S. Centers for Medicare & Medicaid Services set the cap at $33,394. In 2025, this will rise to $34,465. “While the cap is a beneficiary driven cap, meaning the reimbursement allowed per Medicare beneficiary, it is not assessed at the beneficiary level, but rather in the aggregate at the agency provider number level for all beneficiaries served by the agency in the cap,” Rochelle Salinas, vice president of operations for CommonSpirit Health at Home, said. “This allows for greater flexibility in providing care to those in need.” ... [Click on the title's link to continue reading.]

MD Home Health expands services with in-clinic, virtual care, remote patient monitoring, house calls and hospice Longview News-Journal, Phoenix, AZ; by MD Home Health; 10/15/24 Leading Home Health Agency in Arizona launches comprehensive onmnichannel healthcare approach. MD Home Health, a privately-held leading Arizona-based home health agency, today announced the expansion of its healthcare services to include in-clinic care, virtual care, remote patient monitoring, house calls, and hospice, making it one of the first privately-held home health agencies in Arizona to offer a full and comprehensive omnichannel healthcare approach. This expansion allows the firm to broaden its healthcare offering to significantly increase access to comprehensive, quality and convenient healthcare for residents across the Phoenix metro area. "Our new and comprehensive services are designed to ensure that patients have convenient and flexible options to access quality healthcare how, when and where they need it," said David P. Tusa, President and Chief Executive Officer of MD Home Health. 

Millions of aging Americans are facing dementia by themselves California Healthline; by Judith Graham; 10/15/24 Sociologist Elena Portacolone was taken aback. Many of the older adults in San Francisco she visited at home for a research project were confused when she came to the door. They’d forgotten the appointment or couldn’t remember speaking to her. It seemed clear they had some type of cognitive impairment. Yet they were living alone. Portacolone, an associate professor at the University of California-San Francisco, wondered how common this was. Had anyone examined this group? How were they managing? ... Portacolone got to work and now leads the Living Alone With Cognitive Impairment Project at UCSF. The project estimates that that at least 4.3 million people 55 or older who have cognitive impairment or dementia live alone in the United States. ... Imagine what this means. ...

‘It’s more like hope’: New hospice patient’s Halloween wish come true WTOC 11, Pooler, GA; by Jasmine Butler; 10/14/24 Tons of candy, a bunch of costumes and hundreds of people. That is what a neighborhood in Pooler looked like as people gathered for a Layla Alacan, who recently entered Hospice Care. “She is so sweet when she wants to be and she’ll cuddle up and give kisses, she’s the definition of a sour patch kid. She’s super sour and then super sweet after,” said Layla’s mother, Courtney Alacan. She has a big personality, but she’s fighting a big battle. Layla has a rare terminal disorder called 4H Leukodystrophy. ... It’s an experience her parents Courtney and Nick Alacan know all too well. “Our first child Jamie also had the condition. And she unfortunately passed in April of 2023,” said Alacan. So, they’re vowing to make her wildest dreams come true. ... “[We]  asked her what her favorite holiday was and she said Halloween," said Alacan. “Thinking we would have 40 or 50 kids come through and just you know, have a nice little night. Then, it blew up and now we’re here and we couldn’t be more grateful," said Alacan. An entire community, celebrating Halloween a little early but also rooting on the six-year-old with enough spunk, for them all. 

Humana, UnitedHealthcare, Aetna fall in new MA star ratings Modern Healthcare; by Nona Tepper; 10/10/24 The Centers for Medicare and Medicaid Services sought to make it more challenging for Medicare Advantage insurers to win top quality scores and the payment bonuses that go along with them. It's working. On Thursday, CMS released the latest Medicare Advantage star ratings, and the contrast to just a few years ago is stark. In 2022, 74 Medicare Advantage with prescription drug coverage contracts garnered five-out-of-five stars. For the 2025 plan year, only seven did.

A new Hope(West CEO): HopeWest CEO resigns, assures smooth transition The Daily Sentinel, Grand Junction, CO; by Jace Dicola; 10/13/24 HopeWest is on the search for a new Chief Executive Officer.According to current HopeWest CEO Cassie Mitchell, her departure is bittersweet, but the 30-year-old or ganization couldn’t be in better shape for a smooth transition. Mitchell will remain CEO until the end of this year after her successor is selected. HopeWest is a nonprofit provider of the county’s Program of All-Inclusive Care for the Elderly and regional hospice, palliative and grief services. “It’s been a good two and a half years,” Mitchell said. “The organization is in a really strong place: quality is good, sustainability is good and we’re still 100% committed to our nonprofit, community-based mission.” The departure from HopeWest — to return to her home state of Kentucky — stems from a job opportunity in Mitchell’s old stomping grounds that will allow her to help with her faraway family’s “pressing” needs. She will serve as COO for another serious-illness health care provider currently amid a merger between two nonprofits. 

FTC finalizes premerger rule: 9 things to know Becker's Hospital Review; by Alan Condon; 10/10/24 The Federal Trade Commission voted 5-0 to finalize changes to premerger notifications under the Hart-Scott-Rodino Act, which requires organizations to report large transactions to the FTC and Justice Department for antitrust review. "Premerger review is a critical task for the antitrust agencies and to do it well, we need information about each deal's potential antitrust risk," Shaoul Sussman, associate director for litigation of the FTC's bureau of competition, said in an Oct. 10 news release. "This rulemaking is a much needed update to address changes in the marketplace that have undermined the agencies' ability to detect and prevent illegal mergers, while at the same time creating a more efficient review process. Nine things to know: [Click on the title's link for this list.]

More health care teamwork means less burnout: physician survey American Medical Association (AMA); by Georgia Garvey; 10/8/24 Physician burnout is largely influenced by workplace structure and experiences. That is where team-based and safe-care delivery can help, according to a study published in The Joint Commission Journal on Quality and Patient Safety. In the study, “Teamwork Climate, Safety Climate, and Physician Burnout: A National, Cross-Sectional Study,” 1,218 U.S. doctors nationwide were surveyed about burnout and workplace experiences, including teamwork and safety climate. ... The researchers concluded that there is a strong relationship between the amount of teamwork and safety in physicians’ work environments and burnout. It is a relationship that showed improvements on those metrics even when compared with slightly different work climates. Among the physicians surveyed, 27.4% reported high depersonalization, 39.9% reported high emotional exhaustion and 45.6% met the criteria for burnout. But even small increases in teamwork and safety climate were related to improvements in physicians’ feelings of depersonalization, burnout or emotional exhaustion.

Pa. nonprofit to close; more than 100 people to be laid off Penn Live Patriot News; by Daniel Urie; 10/14/24More than 100 people will be laid off at a Philadelphia nonprofit. The Visiting Nurse Association of Greater Philadelphia has filed a Worker Adjustment and Retraining Notification notice with the Pennsylvania Department of Labor & Industry informing the state it will close, and that 114 people will be laid off at 4601 Market St. The nonprofit is expected to close on Oct. 28 but is subject to change based on client needs and operational issues. The Visiting Nurses Association of Greater Philadelphia is closing after 138 years, according to WHYY. The VNA’s home health care program had about 239 patients as of last month, and another 54 patients were being cared for in hospice and palliative care, the WHYY report said. The following employees will be laid off: [Click on the title's link for the list of roles and number of employees.]

Breaks for caregivers: Atlanta nonprofit helps parents of medically fragile children GPB PBS - NPR, Atlanta, GA; by Ambria Burton; 10/14/24 ... The Georgia Division of Family & Children Services (DFCS) defines medically fragile children as children with "medical status that can rapidly deteriorate, resulting in permanent injury or death; one that requires medical care and/or technology to maintain health; and/or a condition that requires extraordinary supervision and observation." The Georgia-based Fragile Kids Foundation reports that there are about 13,000 medically fragile children in Georgia, and the Georgia Pediatric Program (GAPP) requires a waiver to provide services to medically fragile children with multiple system diagnoses, including nursing and personal care support services at homes and communities. The National Center for Pediatric Palliative Care Homes (NCPPCH) aims to provide a pediatric respite home in every state, and Life House Atlanta is a nonprofit public charity aiming to open the first pediatric palliative care home in Atlanta — the first in the Southeast overall.

Kaiser Health Care: Navigating Aging: Older men’s connections often wither when they’re on their own Tahlequah Daily Press; by Judith Graham; 10/12/24 At age 66, South Carolina physician Paul Rousseau decided to retire after tending for decades to the suffering of people who were seriously ill or dying. It was a difficult and emotionally fraught transition. … Seeking a change of venue, Rousseau moved to the mountains. … Soon, a sense of emptiness enveloped him. … His work as a doctor had been all-consuming. Former colleagues didn’t get in touch, nor did he reach out. His wife had passed away after a painful illness, … His isolation mounted as his three dogs, his most reliable companions, died. Rousseau was completely alone — without friends, family, or a professional identity — and overcome by a sense of loss. “I was a somewhat distinguished physician with a 60-page resume,” Rousseau, now 73, wrote in the Journal of the American Geriatrics Society in May. “Now, I’m ‘no one,’ a retired, forgotten old man who dithers away the days.” In some ways, older men living alone are disadvantaged compared with older women in similar circumstances. Research shows that men tend to have fewer friends than women and be less inclined to make new friends. Often, they’re reluctant to ask for help.