Literature Review

Post-acute care faces labor shortage amid immigration scrutiny Modern Healthcare, Post-Acute Care; by Diane Eastabrook; 7/23/25 Nursing homes and home care operators are scrambling to find replacements for foreign-born workers no longer eligible to work in the U.S. due to changes in immigration policy. Providers in Boston, Atlanta and other cities with large populations of immigrants, and Haitians in particular, say the loss of foreign-born workers in an already tight job market is making it increasingly difficult to meet the growing demand for care — and will likely drive up care costs. Last month the Homeland Security Department began notifying more than 500,000 Cubans, Haitians, Nicaraguans and Venezuelans that it terminated a Biden-era program that allowed them to live and work in the U.S. It said those who have not attained legal status to remain in the U.S. outside of the program must leave immediately. Despite court challenges, the federal government also aims to end another program in early September that grants temporary protected status to Haitians and Venezuelans who have lived in the U.S. for more than a decade. [Full access might require subscription.]

Carter, Bera introduce bill to strengthen palliative and hospice care workforce United States Representative Buddy Carter, Washington, DC; Press Release; 7/17/25Reps. Earl L. “Buddy” Carter (R-GA) and Ami Bera, M.D. (D-CA) today introduced the Palliative Care and Hospice Education and Training Act (PCHETA), bipartisan legislation to invest in training, education, and research for the palliative care and hospice workforce, allowing more practitioners to enter these in-demand fields. ... "As a pharmacist, I understand the toll burnout takes on the health care industry, and I am committed to bolstering the workforce so nurses, doctors, and all health care workers can continue to pursue their passion for helping others,” said Rep. Carter. "As a doctor, I know how important it is to provide patients with comfort, clarity, and support when they’re facing serious illness,” said Rep. Bera. “The Palliative Care and Hospice Education and Training Act is a smart, bipartisan step to ensure more health care professionals are trained to deliver this kind of care."Editor's Note: Bravo to this pharmacist and physician bipartisan team for introducing this bill. Go to the article and scroll down to this press release's long list of "Supporting Organizations."

Tracking the Medicare Provisions in the 2025 Reconciliation Bill | KFF KFF; updated 7/8/25 Similar to the chart for Medicaid provisions in the 2025 Reconciliation Bill, KFF also provides details on the changes for Medicare. Topics include eligibility policies, physician payment, prescription drugs, rules for Pharmacy Benefit Managers (PBMs), nursing homes – including the prohibition of implementation, administration, or enforcement of the minimum staffing levels requirement until October 1, 2034, and funding for HHS to “contract with AI contractors and data scientists to identify and reduce Medicare improper payments and recoup overpayments.Guest Editor’s Note, Judi Lund Person: The chart of Medicare provisions confirms that implementation of the Medicare eligibility and enrollment final rule will be delayed until October 1, 2034, except for those provisions that have already taken effect. The Senate version enacted into law also has a temporary one-year increase of 2.5% in the Physician Fee Schedule conversion factor for all services furnished between January 1, 2026 and January 1, 2027 and a delay of the nursing home staffing final rule until October 1, 2034. It is helpful to have the chart in a usable form for reference on the final bill enacted into law.

KFF publishes summaries of Health Provisions in the 2025 Federal Budget Reconciliation BillKFF; updated 7/8/25 On July 3, the House passed the same version of the budget reconciliation bill passed by the Senate on July 1. On July 4, President Trump signed the legislation into law . KFF published this summary to describe the health care provisions in the law (described as the Senate-passed bill) in four categories: Medicaid, the Affordable Care Act, Medicare and Health Savings Accounts (HSAs). It also compares the provisions to a earlier draft of the bill passed by the House on May 22. Guest Editor’s Note, Judi Lund Person:  KFF was formerly known as the Kaiser Family Foundation but since KFF is not a foundation and has no connection to Kaiser Permanente, they are now called simply KFF. They state “As a one-of-a-kind information organization, we bring together substantial capabilities in policy research, polling, and journalism in one organization to meet the need for a trusted, independent source of information on national health issues—one with the scope and reach to be a counterweight to health care’s vested interests and a voice for people.”

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.

Health economic analysis of an all-virtual, at-home acute care modelJAMA Network Open; Brad Spellberg, MD; Christopher Lynch, MD; Hal F. Yee, MD, PhD; Josh Banerjee, MD; 6/25Hospital-at-home care models send staff, durable medical equipment (DME), and therapeutics (eg, intravenous infusions) to patients’ homes to provide care. In the US, Medicare requires in-person evaluations at least twice daily to receive payment for hospital-at-home services. In the UK National Health Service, virtual wards at home are increasingly being used in lieu of inpatient care. This economic evaluation of ... patients receiving all-virtual, at-home acute care ... found that the virtual program was cost-saving (due to avoided variable hospital costs) only for unfunded patients or patients with Medicaid, but was cost-losing for Medicare and commercially insured patients due to substantial lost inpatient revenue. These findings suggest that current payer rates for inpatient care financially disincentivize development and implementation of novel acute, at-home care models, but a simple reimbursement schema could enable net savings to both hospitals and payers.

20 states sue after the Trump administration releases private Medicaid data to deportation officials Associated Press (AP), Washington, DC; by Amanda Seitz and Kimberly Kindy; 7/1/25The Trump administration violated federal privacy laws when it turned over Medicaid data on millions of enrollees to deportation officials last month, California Attorney General Rob Bonta alleged on Tuesday, saying he and 19 other states’ attorneys general have sued over the move. Health secretary Robert F. Kennedy Jr.’s advisers ordered the release of a dataset that includes the private health information of people living in California, Illinois, Washington state, and Washington, D.C., to the Department of Homeland Security, The Associated Press first reported last month. All of those states allow non-U.S. citizens to enroll in Medicaid programs that pay for their expenses using only state taxpayer dollars.

Center for Acute Hospice Care to close in August 29 News, Charlottesville, VA; by Jacob Phillips; 7/1/25 After nearly a decade of offering around-the-clock end-of-life care, Hospice of the Piedmont is closing their Center for Acute Hospice Care (CAHC) on Ivy Road in Charlottesville in August. “It gives us an opportunity to concentrate more on where patients want to be, which is home, and those services will still be provided,” Hospice of the Piedmont President and CEO Nancy Littlefield said. “[CAHC] is a 10-bed unit that we lease...and it’s for patients who might be having needs of a higher level of hospice care.” Littlefield says the main reason for closing the center is the lease is coming to an end and with uncertainty surrounding federal budget cuts of hospice care, continuing in this location is not sustainable. “Our hospice, as well as all hospices across the state, are having to be very cautious about what Medicaid and other reimbursement changes may occur under the current administration,” Littlefield said, “and I think the worst thing we can do for families and patients is to not be prepared.”

The Alliance responds to Senate passage of Reconciliation Bill National Alliance for Care at Home, Alexandira, VA and Washington, DC; Press Release; 7/1/25 The National Alliance for Care at Home (the Alliance) issued the following statement today in response to the Senate’s passage of the “One Big Beautiful Bill Act,” also known as the Reconciliation bill. “The Alliance is alarmed by the Senate’s passage of the One Big Beautiful Bill Act, which prioritizes misplaced budget cuts over the health and wellbeing of our most vulnerable. The legislation will reduce access to care and support for the millions of Americans who rely on home and community-based services (HCBS),” said Alliance CEO Dr. Steve Landers. ... “The Alliance continues to maintain that the complexity of the Medicaid program makes it nearly impossible to reduce expenditures by the amounts contemplated by this legislation – potentially exceeding $1 trillion over ten years – without impacting services to older adults and people with disabilities. The Alliance will advocate on behalf of Medicaid enrollees, families, and providers nationwide ...

Workplace violence bill passes the Oregon House and Senate, heads to Governor's desk The Source, Bend, OR; 6/30/25 The Oregon Legislative Assembly passed groundbreaking workplace violence legislation aimed at keeping frontline healthcare workers safe in hospitals, and home health and hospice settings across Oregon. Senate Bill 537 B (SB 537) was passed by the House just three days after it was passed by the Senate and heads to Governor Kotek for her signature. ... What SB 537 Accomplishes: SB 537 focuses on pragmatic, prevention-oriented solutions that protect frontline nurses and caregivers in hospitals and in home health and hospice settings. ... Why This Matters: ... Nationally, between 2007 and 2022, hospital staff experienced a 181% increase in workplace violence injuries. In Oregon, a staggering 92% of ONA members reported incidents of violence last year—far above national averages.

Solomon Center white paper outlines options to expand health care for children living with serious illnessYale Law School; 6/25/25 As state lawmakers consider establishing a statewide pediatric palliative care program, a new white paper from researchers at the Solomon Center for Health Law and Policy at Yale Law School recommends ways that access to palliative care can be improved for Connecticut’s estimated 7,000+ children living with serious illnesses.

[New York] State Senate passes Medical Aid in Dying Act, bill heads to governor’s desk  Finger Lakes Daily News; by Lucas Day; 6/10/25 The New York State Senate passed the Medical Aid in Dying Act late Monday night, paving the way for New York to become the 11th state in the nation to legalize medical aid in dying. The vote followed hours of contentious debate and passed largely along party lines, 35-27. Six Democrats broke ranks to oppose the measure. The State Assembly had already approved the legislation in April by a vote of 81-67, meaning the bill now heads to Governor Kathy Hochul, who has the final say on whether it becomes law. 

Rosen introduces bipartisan bills to expand access to palliative care, hospice careJacky Rosen, U.S. Senator for Nevada, Washington, DC; 6/5/25 U.S. Senator Jacky Rosen, co-founder and co-chair of the bipartisan Senate Comprehensive Care Caucus, announced the introduction of a pair of bipartisan bills to expand access to palliative and hospice care. The Expanding Access to Palliative Care Act with Senators Barrasso (R-WY), Baldwin (D-WI), and Fischer (R-NE) would establish a demonstration project through Medicare to expand access to palliative care at the time of diagnosis of serious illness or injury. The Improving Access to Transfusion Care for Hospice Patients Act with Senators Barrasso (R-WY) and Baldwin (D-WI) would carve out payment for transfusion services within the Medicare hospice benefit, allowing for separate billing to Medicare for transfusions. This would improve access to hospice care for patients who rely on transfusion care to maintain quality of life.