Literature Review

The Alliance commends introduction of legislation to extend hospice telehealth flexibilities  National Alliance for Care at Home, Alexandria, VA and Washington, DC; Press Release; 2/28/25 The National Alliance for Care at Home (the Alliance) is pleased to support the reintroduction of the Hospice Recertification Flexibility Act in the House of Representatives. This bipartisan legislation, H.R.1720, would extend telehealth flexibilities for hospice face-to-face (F2F) recertification. The F2F encounter is performed by a physician or nurse practitioner to evaluate the patient and collect clinical information used in determining continued eligibility for hospice. Introduced by Representatives Carol Miller (R-WV) and Jared Golden (D-ME), the bill would extend the F2F recertification flexibility for providers until December 31, 2027. Beginning January 1, 2026, the legislation also includes important guardrails to ensure appropriate use and requires the Centers for Medicare & Medicaid Services (CMS) to create a modifier to collect data on when the F2F encounter is conducted via telehealth. The Alliance, then through its legacy organizations, worked with lawmakers to ensure continued care transformation and access to care for high-quality providers. [Click on the title's link to continue reading.]

Hospice of the Piedmont offers discount book, conversation starters for family and friends Augusta Free Press, Waynesboro, VA; by Crystal Graham; 2/26/25 Hospice of the Piedmont has your ticket to discounts at restaurants, theaters, wineries and breweries as well as advice for starting a meaningful conversation with loved ones. ... The printed coupon book offers buy-one-get-one-free entrees, free theater tickets and half price wine tastings. It also includes thoughtful conversation starters designed to spark meaningful discussions with family and friends about life and its final journey. “So much of life happens around the dinner table, at a winery with friends or on a night out at the theater,” said Jenn Downs, chief marketing and development officer at HOP. “We wanted to give people a way to enjoy those experiences while encouraging people to have the kinds of conversations that truly matter.” Editor's note: Applause to Hospice of the Piedmont for this creative, engaging integration of community partnerships (with restaurants, theaters, etc.), hospice fund-raising, and catalyst for meaningful, potentially life-changing dialogues.

Contemporary patterns of end-of-life care among Medicare beneficiaries with advanced cancer JAMA Network - JAMA Health Forum; by Youngmin Kwon, PhD; Xin Hu, PhD, MPSH; Kewei Sylvia Shi, MPH; Jingxuan Zhao, MPH, PhD; Changchuan Jiang, MD, MPH; Qinjin Fan, MS, PhD; Xuesong Han, PhD; Zhiyuan Zheng, PhD; Joan L. Warren, PhD; K. Robin Yabroff, PhD, MBA; 2/21/25Conclusions: In a contemporary cohort of older Medicare decedents originally diagnosed with advanced breast, prostate, pancreatic, or lung cancer, we found that many patients continue to receive potentially aggressive interventions at EOL at the expense of supportive care services. To make meaningful improvements in the quality of EOL care, a multifaceted approach that addresses patient, physician, and system-level factors associated with persistent patterns of potentially aggressive care will be required. Editor's note: Though published just one week ago--February 21--this journal article is already being used extensively, as demonstrated in our posts on 2/24 and 2/25.

New hospice facility to enhance care in Zanesville NBC WHIZ and Fox 5, Zanesville, OH; by Shylin Costello; 2/26/25 A new era of compassionate care is on the horizon as Genesis prepares to build a brand-new hospice care facility on Ashland Avenue in Zanesville. The project comes as the Morrison House, Genesis’ current hospice unit, continues to age. The new facility will enhance hospice care services in the community and provide a more comforting environment for patients and their loved ones. ... “Literally thousands of people have been touched by services at the Morrison House over the last 30 some years. ... Being able to sustain that mission in a new facility is priceless,” CEO of Genesis, Matt Perry said.

‘Global problem’: Numerous factors, biases contribute to overtreatment at end of life Healio; by Josh Friedman; 2/26/25 Nathan I. Cherny, MD, has worked all around the world. At every stop — from Australia to Israel, and Memorial Sloan Kettering Cancer Center in between — he has seen people with cancer receive overly aggressive treatment at the end of life. ... In a review published in ESMO Open, Cherny and a cohort of multinational colleagues highlighted numerous reasons why overtreatment occurs among patients approaching the end of life, ... They listed more than 20 contributing factors, including desire for control of the cancer, denial and anger, family pressure and hope preservation. The two factors that contribute most to overtreatment are optimism bias and the “counterphobic determination to treat,” which involves clinicians having a difficult time introducing the suggestion of palliative care revert to offering further treatments, Cherny said. ... Responsibility for decisions does not need to fall solely on oncologists, Cherny added. Palliative care physicians, social workers, chaplains and others can be part of a team to assist patients with their choices. ... The number of patients who are overtreated differs at each institution. “Each institution has its own culture of care,” Cherny said. Editor's note: This article puts forth significant insights for all palliative and hospice clinicians, interdisciplinary teams, and palliative/hospice executive leaders. Apply Cherny's to your referral sources: "Each institution has its own culture of care." Apply these findings to your own palliative and hospice services. 

[Korea] 9 in 10 Koreans support ending life-prolonging treatment: study The Korea Times; by Kim Hyun-bin; 2/24/25 More than nine out of ten Koreans think that they would opt to forgo life-prolonging treatment if they were terminally ill, a new study has found, highlighting shifting attitudes toward end-of-life care in the country. According to a report released by the Korea Institute for Health and Social Affairs on Sunday, 91.9 percent of respondents expressed they would choose to discontinue life-sustaining treatment if they were diagnosed with a terminal illness or were nearing the end of life, based on a survey conducted last April and May on 1,021 men and women. 8.1 percent stated they would prefer to continue such treatment.

Hospice House seeking to regain tax exemption after losing it this year Owatonna People's Press; by Josh Lafollette; 2/21/25 Despite a few hurdles ahead, there’s a light at the end of the tunnel for the community members seeking to reopen the Homestead Hospice House. After a difficult hiatus, the Hospice House is set to resume serving patients thanks to a partnership with Seasons Hospice, of Rochester. The house, which provided a comforting setting for patients in end-of-life care, closed over a year ago when the previous care provider, Allina Health, discontinued its services there, citing labor reductions within its system and a decline in patients requesting that specific service. Seasons signed a lease with the HHH Board earlier this week. While the future of the house is starting to become clear, the organization is still dealing with the ramifications of Allina’s departure.

Pennsylvania lawmaker introduces ‘No Patient Left Behind Act’ WHTM - PA Homepage; by Brady Doran; 2/19/25 A Pennsylvania lawmaker introduced a bill that would ensure hospitals have visitation policies that balance patient needs with public health protocol. According to Sen. Doug Mastriano (R-33), elderly patients left alone in hospitals experience faster physical and cognitive decline. The No Patient Left Behind Act, introduced by Mastriano, would ensure Pennsylvanians with medical treatment or end-of-life care have support by their sides. “Hospitals should be places of healing. However, for far too many, they have become places of loneliness, despair, and unnecessary suffering,” Mastriano said.

What is death positivity? Phaneuf Funeral Homes & Crematorium, New Hampshire & Vermont; by Phaneuf; 2/19/25 Death positivity is a growing movement that challenges the long-held taboos surrounding death. Rather than shying away from the subject, death positivity encourages individuals and communities to discuss mortality openly. It’s about accepting death as a natural part of life, reducing the fear and stigma often associated with it, and using that acceptance as a foundation for better end-of-life planning and living more fully. Historically, many cultures—including those in the New England region—often treated death as a private, somber affair. Today, however, a new narrative is emerging: one that celebrates the life lived, honors the memories left behind, and helps families make informed, compassionate decisions about the future.

New ACS research finds low uptake of supportive care at the end-of-life for patients with advanced cancer EurekAlert! - American Association for the Advancement of Science (AAAS); Peer-Reviewed Publication by American Cancer Society; 2/21/25  Despite considerable efforts to improve the quality of end-of-life care in the United States, a new retrospective study led by American Cancer Society (ACS) researchers revealed that close to half of patients with advanced cancer received potentially aggressive care at the end-of-life at the expense of supportive care. The findings are out today in the Journal of the American Medical Association (JAMA) Health Forum. ... Study results showed only one-quarter of patients diagnosed with advanced cancer received any palliative care in the last 6 months of life, and those who received it did so mainly in the month of death. Overall, 45% of decedents experienced any indicator of potentially aggressive care. There was an increase in the mean number of acute care visits (from 14.0 to 46.2 per 100 person-months), hospice use (from 6.6 to 73.9 per 100 person-months), palliative care (from 2.6 to 26.1 per 100 person-months), and advanced care planning (from 1.7 to 12.8 per 100 person-months) over the last 6 months of life. ...

Over a quarter of adolescents, young adults with cancer who want to die at home do not Healio; by Jennifer Byrne; 2/20/25 More than one-fourth of adolescents and young adults with cancer who wished to die at home did not attain this goal, according to research published in JAMA Network Open. Researchers conducted a retrospective cohort study that included adolescents and young adults (AYA; age range, 12 to 19 years) with cancer who died between 2003 and 2019. The cohort included patients treated at Dana-Farber Cancer Institute, Kaiser Permanente Northern California or Kaiser Permanente Southern California. ... Healio spoke with Odejide about the rationale for the study, the importance of the findings, and strategies oncologists can employ to ensure more goal-concordant end-of-life care for AYA patients with advanced cancers. [Click here for Helio's discussion with the lead researcher, Oreofe O. Odejide, MD, MPH, associate professor of medicine at Dana-Farber Cancer Institute.]  Editor's note: Examine this JAMA article, which we posted in our Saturday Research issue, 1/18/25: "Preferred and actual location of death in adolescents and young adults with cancer."

Part payer, part provider: VNS Health embraces the futureHome Health Care News; by Joyce Famakinwa; 2/18/25As one of the biggest home-based care organizations in New York, VNS Health is leaning into its size and capabilities. ... “Our real challenge is, how do we leverage the large number of programs and services we already offer to ensure a seamless journey through the most difficult times in a person’s life,” VNS Health CEO and President Dan Savitt told Home Health Care News. ... "Being both a payer and provider allows us an opportunity to work with people in our community throughout their health care journey." ... "We use analytics to identify home care patients with late stage conditions who can benefit from enrollment in our advanced illness management program. Then we use analytics to determine when it may be appropriate to consider moving this patient population into hospice care."