Literature Review

[Korea] Earlier palliative cancer care cuts end-of-life ED visits Medscape; ed. by Gargi Mukherjee; 7/23/25 A recent retrospective study found that earlier outpatient palliative care referrals for patients with advanced cancer were associated with a small increase in overall emergency department (ED) visits but significantly fewer end-of-life ED visits and improved advance care planning. ... A substantial proportion of patients with advanced cancer visited the ED, including during the final month of life. Earlier palliative care referrals were associated with fewer end-of-life ED visits, “emphasizing the importance of timely integration of [palliative care] to reduce unnecessary interventions and ensure goal-concordant care,” the authors wrote. The researchers also noted that the findings underscore the need for structured advance care planning discussions across care settings to enhance the quality of end-of-life care.

Andwell Health Partners CEO: Medicare Advantage becoming  ‘failed policy,’ jeopardizes home health accessHome Health Care News; by Morgan Gonzales; 7/21/25 The rise of Medicare Advantage (MA) has reshaped the home-based care landscape, but it’s putting home health providers in precarious positions while increasingly failing to deliver for beneficiaries. That’s according to the leader of Lewiston, Maine-based nonprofit provider Andwell Health Partners, which has significantly changed the way it cares for patients, including adjusting care plans, to adjust to increased penetration of MA. Andwell Health Partners’ CEO Ken Albert said MA is rapidly becoming a “failed policy,” on a recent episode of Home Health Care News’ Disrupt podcast. Formerly known as Androscoggin Home Healthcare + Hospice, Andwell Health Partners offers home health care, palliative care, hospice services and a slew of other services across Maine. Albert sat down with HHCN to discuss how the nonprofit will survive industry headwinds, the new service lines and innovations he has plotted for the organization, the future of Medicare Advantage and how nonprofit providers have to innovate to survive. 

Public welcomed inside Heather’s House, North Dakota’s 1st freestanding hospice Grand Forks Herald, Fargo, ND; by Robin Hueben and Michael McGurran; 7/22/25 The public is getting its first look inside North Dakota's first freestanding, inpatient hospice house. Several hundred people turned out for a program and open house at HIA Heather's House on Tuesday, July 22, from 10 a.m. to 6 p.m. at 3800 56th Ave. S., Fargo, put on by HIA Health. The letters HIA stand for "hearts in action." HIA had previously been known as Hospice of the Red River Valley before changing its name in June. ... Nancy Andrews, president of the HIA Hospice Board, greeted the crowd on behalf of the board and the facility staff. "I welcome you to the grand opening of this sacred place — a place of peace, compassion and dignity," she said. [For more background, read our 4/23/24 post, Hospice of the Red River Valley celebrates milestone in Heather's House construction.]

Rural hospitals eye service expansions to weather federal cuts Modern Healthcare; by Alex Kacik; 7/14/25 Rural hospitals are hopeful they can add rather than reduce services to help soften the blow from looming Medicaid and Medicare cuts. ...  If rural providers cannot recruit physicians, lean more heavily on philanthropic donors or find other ways to reduce their reliance on Medicaid and Medicare reimbursement to get ahead of cuts in the law, hospitals will be forced to pare back services or close their doors, industry observers said. ... In response, rural providers have accelerated ongoing operational adjustments, including renegotiating vendor contracts, beefing up their coding and billing processes, freezing new hires and standardizing daily tasks to reduce administrative waste. But those tweaks alone cannot sustain rural hospitals, so some providers are aiming to grow surgeries, infusions and other services to boost their bottom lines, executives said.

Ok, please help calm my anxiety. My mother has drastically improved in the last couple of days since goin on hospice. Aging Care; by Oedgar23; 7/17/25 So in the hospital, my mother was in kidney failure. The last couple days after stopping vancomycin for about five days, her GFR had come up to 19. That’s the most recent Number and then they stopped drawing labs because we placed her on Hospice. We consulted with palliative care team. They wanted to do a feeding tube and we said no. They said she had advanced dementia. [Describes improvements since hospice.] ... What if she gets taken off hospice? ... What if she no longer qualifies for hospice, passes as normal cognitively, starts demanding to go home, does not qualify for long-term care, Medicaid, etc. ... But I am super unnerved because she looks a whole lot better than she has been looking. ...Editor's Note: Yes, we all know that the person can get better with hospice care, because of holistic person-centered care, caregiver education and support, and many more factors. This can be confusing. The dying trajectory may have been interrupted or simply calmed with better symptom management and quality of life. This daughter is asking normal, crucial questions which the hospice team needs to be addressing with her. Examine your live discharge data, Policies and Procedures, communication practices with the patient and family about recertifications, Incident Reports from upset caregivers/families, and CAHPS Hospice scores.

[Norway] iLIVE volunteer study: Volunteer and healthcare professional perceptions of newly developed hospital end-of-life-care volunteer services, in five countriesPalliative Medicine; Tamsin McGlinchey, Stephen Mason, Grethe Skorpen Iversen, Dagny Faksvåg Haugen, Inmaculada Ruiz Torreras, Pilar Barnestein Fonseca, Miša Bakan, Berivan Yildiz, Ruthmarijke Smeding, Anne Goossensen, Agnes van der Heide, John Ellershaw; 5/25Volunteer services that provide direct support to patients receiving palliative and end-of-life care in hospitals are new and developing, but little is known about the use and experience of such services from key stakeholders. 20 Volunteers and 20 healthcare professionals were recruited. Three overall themes were generated: (1) Volunteers provided 'unique, distinct, 'community' support' bringing familiarity to an unfamiliar, medically focussed environment. (2) Volunteers were able to 'establish a connection centred on 'being there' within the acute hospital environment' despite the fast paced and highly changeable environment. (3) Through 'relational interactions adapted to the individual person' volunteers attended to patients' existential and emotional needs. These services confer benefits that are transferrable across cultures and countries, 'fusing' formal care with the informal visiting of family or friends, attending to patients' existential needs.

Agrace opens western Wisconsin office in La Crosse WisBusiness, La Crosse, WI; Press Release; 7/16/25 Agrace continues its rapid growth across the state of Wisconsin with the opening of a new office in La Crosse, a western-Wisconsin city of 52,000 located along the Mississippi River. Since its founding in Madison, Wis., in 1978, Agrace has provided exceptional care for the state’s residents who are in the final months of life. The new Agrace location gives residents of La Crosse County greater choice for high-quality, in-home hospice care. County residents can enroll with Wisconsin’s largest nonprofit hospice to receive hospice care that comes to them where they live—in private homes, long-term care facilities or any other place they call home.

Leveraging speedy admissions to support hospice growth Hospice News; by Jim Parker; 7/16/25 Seamless and fast admissions processes are crucial to hospice growth. Speedy hospice patient admissions can lead to improved referral numbers, profitability and length of stay. Yet, hospices need to carefully navigate their patient admission processes to maximize both quality and their revenue. The hospices that do this effectively have a core set of key performance indicators that they look at consistently, according to Tony Kudner, chief strategy officer of the consulting firm Transcend Strategy Group. “The ones that look at data and are constantly asking themselves, ‘How can we paint the fullest picture of eligibility and get to that patient as quickly as possible?’ are the ones that we would say are the ones that are successful,” Kudner told Hospice News. “The people who have that information at their fingertips and use it to drive decision making are usually the ones who are sustaining their organizations and growing.”

Video palliative care improves symptoms but not outcomes in rural hospitals, study reveals McKnights Long-Term Care News; by Donna Shryer; 7/15/25 Researchers from the University of Alabama at Birmingham recently studied whether video consultations could improve palliative care for patients age 55 and older in small hospitals lacking specialized end-of-life services. Participants had an average age of 73. The study, published in JAMA Network Open, found that culturally tailored video consultations — designed with community input to reflect patients’ cultural values and communication preferences — led to a clinically meaningful but not statistically significant reduction in symptom distress. ... [The] video consultations had little effect on hospital readmissions or emergency department visits. The research addressed a critical healthcare gap, as the study notes that only 70% of the Deep South has access to palliative care services, compared to 85-94% in other US regions. This disparity particularly affects rural communities where specialized end-of-life care is often unavailable. 

Time and location of specialty palliative care for women dying with metastatic breast cancer Breast Cancer Research and Treatment; by Andrea King, Cynthia Ortiz, Rachna Goswami, Tara L Kaufmann, MinJae Lee, Lynn Ibekwe-Agunanna, Navid Sadeghi, Donghan M Yang, Lindsay G Cowell, Timothy P Hogan, Lauren P Wallner, Megan A Mullins; 7/15/25 online ahead of print Background: Despite guideline recommendations, evidence suggests many women with metastatic breast cancer (mBC) do not receive specialty palliative care services despite high morbidity burden. ... Results: ... Most palliative care encounters were inpatient and occurred within ~ 1 month of death. ...Conclusion: Palliative care for women with mBC is infrequent and often late, with referrals seemingly driven by the imminence of death rather than metastatic diagnosis. Strategies to better identify and triage specialty palliative care needs and make timely referrals are needed.

VA announces expanded burial benefits for those under VA-provided hospice care Tri-State Alert; by Staff Report; 7/11/25 The Department of Veterans Affairs announced today it has temporarily expanded burial benefits for certain Veterans, per the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act. The new law specifies eligible Veterans are those who are discharged from VA-provided medical or nursing care to receive VA-provided hospice care at their home and who pass away between July 1, 2025, and Oct. 1, 2026. Previously, Veterans who died at home under VA hospice care after discharge from VA-provided medical or nursing care were not always eligible for a full VA burial allowance. The Dole Act addresses that gap.

Addressing the underutilization of hospice care in Asian American communities: A scoping reviewAmerican Journal of Hospice and Palliative Medicine; Tuzhen Xu, PhD, APRN, FNP-C; Dan Song, PhD, RN; Gloria M. Rose, PhD, NP-C; 6/25Despite national improvements in hospice care, utilization remains low among Asian American (AA) communities. Identified barriers to hospice utilization included language and communication challenges; cultural values and beliefs surrounding death; family-centered decision-making and filial piety; religious influences such as beliefs in karma and suffering; and broader issues like low acculturation and mistrust of the healthcare system. Comprehensive cultural competence training is needed for healthcare providers, especially physicians, nurse practitioners, registered nurses, and social workers involved in hospice and palliative care.