Literature Review

The powerful companies driving local drugstores out of business DNYUZ; 10/19/24 The small-town drugstore closed for the last time on a clear and chilly afternoon in February. Jon Jacobs, who owned Yough Valley Pharmacy, hugged his employees goodbye. He cleared the shelves and packed pill bottles into plastic bins. Mr. Jacobs, a 70-year-old pharmacist, had spent more than half his life building his drugstore into a bedrock of Confluence, Pa., a rural community of roughly 1,000 people. Now the town was losing its only health care provider. Obscure but powerful health care middlemen — companies known as pharmacy benefit managers, or P.B.M.s — had destroyed his business. This has been happening all over the country, a New York Times investigation found. P.B.M.s, which employers and government programs hire to oversee prescription drug benefits, have been systematically underpaying small pharmacies, helping to drive hundreds out of business.

HealthRev Partners and Trella Health announce partnership to empower home health and hospice agencies The Warren Record; by Trella Health; 10/17/24HealthRev Partners, [a] revenue cycle management partner specializing in innovative, tech-driven solutions for home health and hospice agencies, and Trella Health, [a] provider of market intelligence and Customer Relationship Management (CRM) solutions for the post-acute care industry, have announced a new partnership. HealthRev Partners and Trella Health will collaborate to help agencies reach their full potential by cultivating stronger relationships with referral sources and optimizing their revenue cycle through complementary solutions.

AAHPM Board President: Telehealth access ‘critical’ for hospice patientsHospice News; by Jim Parker; 10/17/24 The forthcoming expiration of telehealth flexibilities implemented during the pandemic could have a devastating impact on vulnerable populations, including those receiving hospice or palliative care. This is according to Dr. Holly Yang, board president of the American Academy of Hospice and Palliative Medicine (AAHPM). Currently, temporary federal rules allowing for greater access to telehealth are set to expire on Dec. 31. While legislation is in play to extend them, the outcome is uncertain, and the end of the year is approaching. Hospice News sat down with Yang to discuss the importance of these flexibilities and how their impending departure could impact patients and families, particularly those in rural areas or with limited mobility, poor health equity or social determinants of health needs.

A ‘second wave’ of medical issues may slam the region in Helene’s wake, disaster response officials caution NC Health News, by Asheville Watchdog; 10/12/24 After the floods come the waves. Following the initial health crises in the aftermath of tropical storm Helene, Buncombe County and others inundated by the storm may be facing a secondary medical surge, one driven by infections and diseases and potentially exacerbated by a lack of running water, emergency response officials warned. Helene’s initial devastation in western North Carolina sent hundreds to the hospital with needs for everything from oxygen to traumatic wound care. Now, two weeks after the storm, doctors, health professionals and officials in charge of disaster relief say there could be a second wave of medical concerns affecting hospitals and clinics, and it could be here soon. … “The health consequences of flooding may be described in terms of time as immediate, medium-term, and long-term,” a 2009 study on the health impacts of floods said. “[I]mmediate is considered as the period when the flood is present, medium is the immediate recovery phase (days to weeks), and long-term is the reconstruction phase (months to years) after the flood.”

Hurricane Milton challenges home-based care's adaptability Modern Healthcare; by Diane Eastabrook; 10/9/24 [Note, posted just prior to landfall, Wed. Oct. 9.] Hurricane Milton is set to test the resilience of home-based care providers along the west coast of Florida. While hundreds of healthcare sites reported evacuations ahead of the hurricane, some companies that provide care to patients where they live, including CenterWell and Medically Home, continued to send staff into patients’ homes in the hours before the storm hit. Many home-based care companies are ready to activate contingency plans to keep providing care to patients during and after the hurricane. ... Here is how some home-based care providers prepared for Hurricane Milton. ...

AMA Journal of Ethics: Educational resources in response to medical supplies lost to hurricaneEmail from AMA Journal of Ethics; 10/10/24Storm damage from hurricane Helene has forced a factory that makes medical supplies to shut down. The AMA Journal of Ethics offers the following educational resources:

Concurrent/simultaneous services from Hospice and a Home and Community Based Services waiver Media.Alabama.gov; State of Alabama Press Release - Medicaid; 10/8/24 The Alabama Medicaid Agency (Medicaid) updated the policy to allow concurrent services from hospice and a Home and Community-Based Services (HCBS) Waiver. However, it is vital that the hospice and HCBS waiver case manager coordinate to avoid duplication of services. The HCBS waiver person-centered care plan (PCCP) and hospice plan of care (POC) of the recipient should be coordinated between the hospice, HCBS waiver case manager, and the recipient and his/her caregiver. A conference that includes these parties must be held before concurrent services can start.  The PCCP/POC conference shall be documented in both the recipient’s hospice and waiver record. The PCCP/POC should specify all concurrent services, the frequency of services, and which entity will provide the service. Each HCBS Waiver service included in the PCCP/POC should have an explanation as to why the service is not covered under hospice. [Click on the title's link for more information.] 

Helene will likely cause thousands of deaths over decades, study suggests USA Today; by Doyle Rice; 10/2/24 [Note the 10/2 date of this article. Helene's death toll is now 230+ and rising. Hurricane Milton's predictions were new.] A new study ... says that hurricanes and tropical storms are far deadlier than initial death tolls suggest. ... Overall, the death toll of a tropical cyclone may be a broader public health issue than previously thought, as disasters frequently trigger a domino effect of other threats to affected populations. ... Researchers found that these excess deaths were due to causes such as diabetes, suicide, sudden infant death syndrome or another cause that was not recorded. Cardiovascular disease was the next most common cause, followed by cancer. Official government statistics record only the number of individuals killed during these storms. Usually, these direct deaths, which average 24 per storm in official estimates, occur through drowning or some other type of trauma, according to the study. "People are dying earlier than they would have if the storm hadn't hit their community," said senior study author Solomon Hsiang, a professor of environmental social sciences at Stanford University. Looking at the death and destruction from Helene, Hsiang told the Associated Press that "Watching what’s happened here makes you think that this is going to be a decade of hardship on tap, not just what’s happening over the next couple of weeks.”

Sixty-four Fla.-based healthcare facilities report evacuations  Healthcare Purchasing News - Regulatory; by Janette Wider; 10/8/24 Ahead of Hurricane Milton the Agency for Health Care Administration initiated an event in the Health Facility Reporting System. ... Health care providers have been requested to provide information on census, available beds, evacuation status, accepting evacuees and generator needs from counties declared under EO-24-114. This information allows AHCA to assist health care providers in transferring patients if needed and ensure that health care providers in impacted areas have the necessary resources and adequate power. 64 health care facilities have reported evacuations. This includes:

Empath Health established Hurricane Helene Assistance Fund to support colleagues South Florida Hospital and Heaclthcare Report; by Victoria Tanner; 10/6/24 At Empath Health, we believe that caring for our colleagues is just as essential as caring for our patients and families. In response to the recent devastation caused by Hurricane Helene, we have established a special Hurricane Helene Assistance Fund within our Colleague Assistance Fund (CAF) to offer immediate financial relief to colleagues who have been impacted by the storm. This fund is designed to help those facing unexpected expenses, such as temporary housing, home repairs, and other essential needs that have arisen in the wake of the hurricane. By creating this targeted fund, we aim to ensure that our team members can access the resources they need to recover and rebuild during this difficult time. “Our colleagues are the heart of our mission, and in times of crisis, we stand by them just as they stand by our patients,” said Jonathan Fleece, President and CEO of Empath Health. “This fund allows us to help those who give so much to others, ensuring they have the support they need when it matters most.” ... Hurricane Helene, which impacted West Central Florida on [September 26], stands as the most severe storm to hit the region in over a century. Empath Health, with over 3,000 colleagues, serves communities across 20 counties, stretching from Collier County in the south to Marion County in the north. Editor's note: We understand that contributions are made by Empath's colleagues. For other, hospice contributions (especially links where the general public can contribute to hospice staff and/or hospice needs, please contact us via these links, Editor and/or Publisher. Thank you.

Hospice ‘license flipping’ still plagues sector, though regulations help Hospice News; by Jim Parker; 10/3/24  “Shady” brokers allegedly continue to facilitate “license flipping” among fraudulent hospices, though new regulations have started bearing down on the practice. Soon after obtaining them, or before regulators can act on alleged malfeasance, according to several industry sources who spoke with Hospice News. The practice appears to stem from a rash of newly licensed hospices that have emerged in California, Nevada, Texas and Arizona – states identified by federal watchdogs as hotspots for hospice fraud. Many of these sales involve certain brokers who move the licenses between owners. “There’s a lot of shady people out there, and they put a high value on their agencies. Right now they’re selling like hot tamales from anywhere between $300,000 to $500,000 per license,” one former hospice leader told Hospice News on condition of anonymity. “They’re all done through the same brokers and the same people.”  

Amazon Wish List for 3 hospices impacted by Hurricane HeleneWe have gathered a list of items needed by each of our member organizations that were significantly impacted by Hurricane Helene.  If you are interested in donating items, please click on the links below to make a purchase.  The items will be shipped directly to the member organization(s).  Wish lists from member organizations:

Asian-American communities face ‘digital divide’ in health equity, hospice care Hospice News; by Holly Vossel; 10/1/24 Recent research has dug into the barriers limiting greater telehealth utilization among Asian American, Native Hawaiian and Pacific Islander (AANHPI) communities. The data come at a time when hospices are striving to better understand how to improve those groups’ end-of-life trajectories. Technology utilization has gained momentum in health care, including in hospice care delivery. Though increased virtual health care access can help hospice providers reach patients upstream, the trend may be worsening disparities and outcomes among Asian American populations, according to Victoria Tsze, an outpatient hospice social worker at Tucson Medical Center (TMC) Hospice.