Literature Review

Hospice workers call for Gov. Hochul to sign bill restricting for-profit hospices WSKG/PBS/NPR Buffalo Toronto Public Media; by Emyle Watkins; 11/14/25 A medical campus that once made history is renewing calls for better patient care. Hospice and Palliative Care Buffalo, a non-profit, opened the first combined residential and in-patient hospice campus in the United States 30 years ago. On Thursday, workers at this campus gathered to call on Governor Kathy Hochul to sign legislation preventing for-profit hospices from growing or opening until better patient safeguards are in place. Jeanne Chirico, the president of the Hospice and Palliative Care Association of New York State, says, "Why is that important? Because evidence from across the country has shown us what happens when hospice becomes a business model instead of a mission."

Integrated clinical-social care and boundaries of health careJAMA Health Forum; by Vincent Guilamo-Ramos, Marco Thimm-Kaiser, Adam Benzekri, Kody H. Kinsley; 10/25After a decade of growing momentum, the future role of health care in addressing patients’ health-related social needs (HRSNs) through integrated clinical-social care is uncertain. There is agreement that increasing health care expenditures are a significant burden on the national budget, but there is disagreement over remedies to reduce costs while improving outcomes. We argue that a constructive debate over the role of integrated clinical-social care within health care reforms requires a shared vision for its implementation. We advance this debate by delineating the boundaries of what the health care system, social welfare system, and bridging infrastructure between them can deliver in an integrated clinical-social care paradigm.

TRUE Palliative Care launches as California strengthens commitment to compassionate care under SB 403 Pal Item, San Diego, CA; by TRUE Palliative Care; 10/28/25 Following California’s landmark decision to make the End of Life Option Act permanent under Senate Bill 403, a new chapter of compassionate healthcare has begun. Today, palliative care pioneer Dr. Bob Uslander announced the official launch of TRUE Palliative Care (TPC), an evolution of in-home, whole-person care designed to support patients and families living with serious or chronic illness, long before hospice begins.

Ana Maria Rodriguez files a bill to better ensure patient choices are honored in end-of-life care Florida Politics; by Andrew Powell; 10/31/25 Sen. Ana Maria Rodriguez wants to make sure physicians follow directives from Florida patients who communicate and preauthorize end-of-life care preferences. Those can include pain management choices and interventions that artificially prolong the process of dying. The Doral Republican filed a bill (SB 312) that aims to establish and regulate “patient-directed medical orders” within Florida law, ensuring that patient preferences, such as withholding or withdrawing life-sustaining interventions, are honored and respected across health care settings.

Palliative care legislation exploding at state level, but policy gaps remain, study reveals McKnights Home Care: by Adam Healy; 10/27/25 States are becoming increasingly focused on palliative care. Since 2009, the number of palliative care-related bills introduced at the state level has grown at a rapid pace, according to a new study published in JAMA Network Open. ... Of the 819 bills introduced between 2009 and 2023, roughly 30% were eventually passed into law. ... Bills related to palliative care quality and public awareness bills were the most likely to pass, it found. Meanwhile, relatively few bills governing palliative care workforce, clinical skill building and patient rights passed during the study period.

AHA responds to OSTP request on AI policies for health care American Hospital Association; by Ashley Thompson, AHA Senior Vice President, Public Policy Analysis and Development; 10/27/25 ... On behalf of our nearly 5,000 member hospitals, health systems and other health care organizations, our clinician partners — including more than 270,000 affiliated physicians, 2 million nurses and other caregivers — and the 43,000 health care leaders who belong to our professional membership groups, the American Hospital Association (AHA) appreciates the opportunity to provide comment on the Office of Science and Technology Policy (OSTP) request for information (RFI) regarding regulatory reform on artificial intelligence (AI). ... [Our] members have urged that policy frameworks strike the appropriate balance of flexibility to enable innovation while ensuring patient safety. The AHA offers four categories of recommendations to maximize the potential for AI to improve care, accelerate innovation and support the health care workforce.

The government shutdown’s impact on Medicare Advantage: As clear as mud? JD Supra; by Jeffrey Davis and Lynn Nonnemaker; 10/16/25 Over the last couple of weeks, stakeholders have raised many questions about how the government shutdown will affect different healthcare initiatives and programs, and Medicare Advantage (MA) is no exception. The Centers for Medicare & Medicaid Services (CMS) has provided guidance related to Medicare claims processing, telehealth services, and other operations, but most of that has pertained to Medicare fee-for-service (traditional Medicare). MA plans have been largely responsible for figuring out how the information applies to them. About half of Medicare beneficiaries are in MA, meaning more than 35 million Medicare beneficiaries and the providers who care for them rely on MA plans to communicate how benefits and coverage have, or have not, changed. As the shutdown drags on, CMS’s work to establish future MA policies and payment rates through rulemaking and notices also could be impeded. To discuss some of the ways that the shutdown has impacted MA and may continue to do so, I’m bringing in my colleague Lynn Nonnemaker. ...

Impact of the Affordable Care Act on palliative and hospice care utilization among patients with gastrointestinal cancers: An interrupted time series analysisJournal of Palliative Medicine; by Eshetu Worku, Selamawit Woldesenbet, Mujtaba Khalil, Timothy M Pawlik; 9/25The Affordable Care Act (ACA) aimed to expand insurance coverage, improve health outcomes, and reduce costs. We assessed the impact of the ACA on hospice or palliative care utilization among [Medicare] patients with stage IV gastrointestinal (GI) cancer. Patients from minority racial groups ... and those in moderate ... and high ... Social Vulnerability Index (SVI) counties were less likely to use palliative care in both pre- and post-ACA eras. Palliative care use was associated with $2,633 lower total expenditure. Conclusion: ACA implementation did not improve palliative care utilization for racial minorities and high SVI groups.

Bipartisan group of N.Y. legislators urge Hochul to sign bill preventing for-profit hospice expansion Spectrum News 1, Northern New York; by Susan Arbetter; 10/9/25 Because hospice care doesn’t provide curative treatment, for-profit companies, including private equity firms, are swiftly entering the field because they can make a lot of money. It hasn’t worked out well. In New York state, there are 39 not-for-profit hospice programs and two for-profit. There are those who point to the state’s low hospice utilization rate and say the answer is to open the state up to more for-profit hospice. State Sen. Liz Krueger, a Democrat from Manhattan, and state Assemblyman Brian Maher, a Republican from the Hudson Valley, both strongly disagree.

Telepalliation creates a sense of security: A qualitative study of patients with cancer receiving palliative carePalliative Medicine; by Jarl Voss Andersen Sigaard, Elisabet Dortea Ragnvaldsdóttir Joensen, Una Rósa Birgisdóttir, Helle Spindler, Birthe Dinesen; 10/7/25 ... The aim of this study was to explore patients' experiences with the functionality of the Telepalliation program while receiving specialized palliative care. ... Results: Four key themes emerged: "Sense of coherence," "Telepal platform," "Roles of spouse/partner and relatives," and "Cross-sector collaboration." The program improved patients' sense of security and coherence by enhancing communication with healthcare professionals. ... The platform also successfully integrated relatives into the care process. Editor's Note: While this research was conducted in Denmark, it surely resonates with patient care in the US. Reference articles in the uncertainties of government shutdowns, legislative needs to extend telehealth, and more: 

Wisconsin rarely grants compassionate release as aging, ailing prisoners stress systems Wisconsin Watch; by Mario Koran and Sreejita Patra; 10/7/25 Increased use of compassionate release could ease costs and crowding with minimal risks to public safety, experts say. But it remains off limits to many prisoners. ... Wisconsin grants few applicants compassionate release, leaving many severely ill inmates in short-staffed prisons that often struggle to meet health care needs. Wisconsin courts approved just 53, or 11%, of 489 compassionate release petitions they received between January 2019 and June 2025 — about eight petitions a year, Corrections data show. Courts approved just five of 63 petitions filed in all of 2024. 

What is water cremation and why did Pa. lawmakers just back a bill to legalize it? LeighValleyLive.com, Leigh Valley, PA; by Lehigh Valley Community News; 10/5/25 The Pennsylvania House of Representatives passed bipartisan legislation on Wednesday authorizing alkaline hydrolysis, commonly known as water cremation, as an approved cremation method in the state. The bill would give Pennsylvania families a more environmentally sustainable option for end-of-life services. Alkaline hydrolysis uses a mixture of water and alkali in a sealed pressurized steel chamber to reduce the body to bone, which is then processed into ash. The process consumes significantly less energy than traditional flame cremation, which requires temperatures exceeding 1,600 degrees Fahrenheit. According to the Mayo Clinic, alkaline hydrolysis uses only about one-quarter of the energy required for flame cremation. 

CMS issues memo with contingency plans for state survey & certification activities in the event of federal government shutdown CMS - Center for Clinical Standards and Quality; by CMS Directors, Quality, Safety & Oversight Group (QSOG) and Survey & Operations Group (SOG); 10/1/25 On October 1, 2025, CMS issued QSO-26-01-ALL identifying State Survey and Certification functions that (a) are not affected by a Federal shutdown, (b) excepted functions that are to be continued in the event of a shutdown (also referred to as “essential functions”), and (c) other activities that are directly affected and therefore should not be operational during a Federal shutdown. CMS also clarified that Hospice Surveys funded through the Consolidated Appropriations Act (CAA) of 2021are considered mandatory and are not impacted by the Federal Government shutdown. Work funded under these sources should continue.