Literature Review

Medicare Advantage prior authorization: The impact - increased access to care HHS-OIG; 3/19/24 HHS-OIG’s work on this issue drew national attention to the problem spurring the Centers for Medicare & Medicaid Services, the Industry, and Congress to action.  Editor's Note: You can download the "Impact Brief" from this site. Click on the title's link.

Use of machine learning to optimize referral for early palliative care: Are prognostic predictions enough  Journal of Clinical Oncology - Editorials; by Gary E. Weissman, MD, MSHP; Joseph A. Greer, PhD; and Jennifer S. Temel, MD; 3/15/24  The Takeaway In the article that accompanies this editorial, [Weissman] et al used a machine learning (ML) algorithm to identify patients with advanced cancer who were receiving non–curative-intent treatment and at risk of death within 1 year to allocate early palliative care services at least 6 months before death as a means to increase use of early palliative care in the context of limited resources. While ML prognostic models are one promising strategy for triaging palliative care services, initiation of palliative care based exclusively on estimated survival and in the months before death likely excludes patients who would benefit from early palliative care initiated at the time of diagnosis, regardless of their estimated survival.

Telehealth study investigates reimbursements for rural health care deliveryMedical Xpress, by Vincent Jacobbi, Mayo Clinic; 3/15/24A recent Mayo Clinic study published in the American Journal of Hospice and Palliative Medicine investigated how telehealth in palliative care may provide value for rural caregivers, health care teams and their patients. Researchers were particularly interested in determining what billing models were most cost-effective and sustainable for health care teams and caregivers transitioning patients from hospital to home care

Palliative and end-of-life care in hematologic malignancies: Progress and opportunities JCO Oncology Practice, by Mazie Tsang, MD, MAS, MS and Thomas W. LeBlanc, MD, MA, MHS, FAAHPM, FASC; 3/13/24 ... An important finding from this study was the qualitative data from narratives of volunteer caregivers and hospice staff that described daily patient care, changes in patient status, perceived symptom burden, and indications for medication administration. The authors identified skin integrity concerns, bleeding, pathologic fractures, and delirium as unique issues for patients with hematologic malignancies enrolled on hospice. ... These findings provide further evidence that hospice care can and does work well for some patients with hematologic malignancies. 

'It's been really inspiring': Grace House continues end-of-life care despite challenges Akron Beacon Journal, by Kelsie Horner; 3/13/24Through a flood and financial challenges, an Akron nonprofit has continued to provide end-of-life care and companionship for people who might otherwise die alone. Since opening its doors 1½ years ago, Grace House has cared for 66 residents during their final days. ... Grace House is one of only three organizations in the nation to provide free, “non-barrier” end-of-life care for people who are unhoused or alone.

Can we make more accurate prognoses during last days of life?Journal of Palliative Medicine; by Sylvie Bouchard, Andreea Paula Iancu, Elena Neamt, François Collette, Sylvie Dufresne, Patricia Maureen Guercin, Suganthiny Jeyaganth, Desanka Kovacina, Taliá Malagón, Laurie Musgrave, Marilisa Romano, Jenny Wong, Sybil Skinner-Robertson; 3/8/24Background: ... Established methods (Palliative Performance Scale [PPS], Palliative Prognostic Index [PPI]) have been validated for intermediate- to long-term prognoses, but last-weeks-of-life prognosis has not been well studied. Patients admitted to a palliative care facility often have a life expectancy of less than three weeks. Reliable last-weeks-of-life prognostic tools are needed. Conclusions: ... Using SPS [Short-Term Prognosis Signs] along with PPS and PPI during the last weeks of life could enable a more precise short-term survival prediction across various end-of-life diagnoses. The translation of this research into clinical practice could lead to a better adapted treatment, the identification of a most appropriate care setting for patients, and improved communication of prognosis with patients and families.

Oncology hospitalists improve hospice transitions for patients with advanced cancers Yale School of Medicine, by Osman Moneer; 3/11/24Unplanned hospitalizations for patients with advanced cancer often trigger discussions about care goals and transitions to hospice. Late referrals to hospice, particularly near the end of life, have been associated with reduced quality of life and increased healthcare costs. A new research study published in Cancer investigates the impact of oncology hospitalists on the timing of hospice transitions for patients with advanced cancers. 

Spiritual care key to addressing disparities among underserved black communities Hospice News, by Holly Vossel; 3/11/24Spiritual hospice care providers are an important link to building bridges of access and trust among underserved African American populations. ... Having a historical context of understanding around the faith-based barriers among African American populations is a significant part of improving utilization, according to Wayman Scott, associate director of diversity, equity, inclusion and community relations at Maryland-based Gilchrist. Scott also has a background in hospice chaplaincy and serves as chair of the diversity committee at the Hospice & Palliative Network of Maryland.

CT bill would create a statewide pediatric hospice program: 'Make this a reality for our children' The Darien Times, by Cris Villalonga-Vivoni; 3/11/24There are only a handful of agencies specifically providing end-of-life care to children in the state, said Moss, who is also the founder of Connecticut Children’s Hospital palliative care team, the Sunflower Kids. “Every dying child in the state of Connecticut deserves this expertise and support of the hospice program,” Moss said. “It is time we make this a reality for our children.” The need for pediatric hospice care is felt throughout the state, even if the volume of people seeking out these services is often low, said Tracy Wodatch, president and chief executive officer of the Connecticut Association for Healthcare at Home.

How changing reproductive health laws could impact perinatal hospice Hospice News, by Holly Vossel; 3/8/24 Evolutions in reproductive health laws may have reverberating impacts on the demand and delivery of perinatal hospice care. Perinatal hospice care is provided to families choosing to continue a pregnancy following a life-limiting prenatal diagnosis indicating a high risk of mortality before or shortly after birth. This care includes emotional, spiritual and medical support to families navigating the complexities of a terminal illness. Perinatal hospice providers work closely with health care professionals in neonatal intensive care units (NICU) and reproductive health settings. 

I have little time left. I hope my goodbye inspires you. The Washington Post, by Amy Ettinger; 3/9/24 This past summer, at age 49, I was diagnosed with a rare, incurable cancer called leiomyosarcoma. ... My symptoms were getting worse. I had swelling in my abdomen and legs that couldn’t be treated. After a while, I could no longer walk up the stairs of my house. I decided I wanted comfort, and this week I made the decision to transition to hospice. After choosing this path, I reflected on some of the things I was able to do since my diagnosis: ... People are often afraid when they hear the word “hospice,” but for me it’s been a positive experience. Editor's Note: Read and share this inspiring personal story about choosing hospice care. This is not about Medical Assistance In Dying (MAID), thus eliminating controversial perspectives.

The Joint Commission, Kaiser Permanente announce application period for 2024 Bernard J. Tyson National Award for Excellence in Pursuit of Healthcare Equity GlobeNewswire, by The Joint Commission; 3/5/24 The Joint Commission and Kaiser Permanente are now accepting applications for the 2024 Bernard J. Tyson National Award for Excellence in Pursuit of Healthcare Equity. The award program will recognize a healthcare organization that led an initiative that achieved a measurable, sustained reduction in one or more disparities. Bernard J. Tyson, the late CEO and chairman of Kaiser Permanente, worked tirelessly to address the disparities that plague the U.S. healthcare system. Now in its fourth year, the award honors Tyson’s legacy by presenting organizations the opportunity to earn national recognition for their efforts to improve healthcare equity, as well as share best practices and lessons learned with thousands of organizations across the country.