Literature Review

Health policy challenges for 2025 and beyondJAMA Health Forum; Lanhee J. Chen, JD, PhD; 1/25Despite multiple reform attempts, the US health care system is still burdened by high costs, limited access to quality care, and policies that have resulted in the inefficient delivery of care. However, technological advances, insights from the COVID-19 pandemic, and approaching policy deadlines, such as expiration at the end of 2025 of enhanced coverage subsidies available through the Affordable Care Act (ACA), offer policymakers a reason to act. The next few years will present policymakers with opportunities to address key health care challenges, including the future of Medicare, the continuing implementation of the ACA, and the health care provisions included in the federal tax code. The new administration and Congress will have their hands full in 2025 because the expiring tax and subsidy provisions are action-forcing events. Lawmakers will face a unique opportunity to reform the system in a way that improves accessibility and affordability and enforces some measure of fiscal discipline, and to make decisions that could positively affect the future of health care for millions of individuals in the US.

Hospice advocates push bill for a third time despite two Hochul vetoes Spectrum News 1, New York State; by susan Arbetter; 2/12/25 Last spring, Capital Tonight sounded an alarm about for-profit hospice care. The Federal Bureau of Investigation (FBI) had just issued public warnings about for-profit hospice fraud in four states; it was alerting consumers to a scam in which patients were being enrolled without their knowledge by recruiters who were “selling” hospice to people who weren’t eligible. Hospice fraud like this has also been extensively reported by The New Yorker and Pro Publica. After Gov. Kathy Hochul twice vetoed a bill preventing the expansion of for-profit hospice in New York, a new bill (S.3437/ A. 565) is being introduced by the chair of the state Senate Finance Committee, Liz Krueger, and chair of the state Assembly Health Committee, Amy Paulin. “If a family is faced with a loved one that is dying, they should not also be faced with the possible incentive of money,” Assembly member Paulin told Capital Tonight. There are a variety of drawbacks to for-profit care, and there is clear data that shows profit motives drive for-profit hospice to neglect patient care and prioritize volume over quality.

Access tops list of Americans' healthcare concerns: 4 survey findings Becker's Clinical Leadership; by Erica Carbajal; 2/5/25A quarter of Americans rank healthcare access and affordability as the top public health priority they want government leaders to focus on, according to poll findings from Gallup and Emory University's Rollins School of Public Health. ... Four key findings:

Montana bill to outlaw physician-assisted death clears Senate Ravalli Republic; by Carly Graf; 2/7/25 The proposal would prohibit a health care provider from prescribing life-ending drugs at the request of a terminally ill patient. That ability currently exists largely due to a legal loophole. [Article is behind a paywall.]

Immigration policies’ ‘chilling effect’ on the hospice workforce Hospice News; by Holly Vossel; 2/5/24 The White House recently issued several executive orders that have ramped up the nation’s immigration enforcement policies. The health care sector may be facing a host of staffing and operational challenges as the regulatory moves unfold, according to Hannah Liu, manager of immigration advocacy at Asian Americans Advancing Justice (AAJC). A tightening of immigration policies has come with “concern, panic and confusion” across diverse communities nationwide, Liu stated. “As the effects of these hostile immigration policies play out, patients may also face the life-or-death situations that arise from interruptions in care caused by staffing shortages,” Liu told Hospice News in an email. “Immigrants in the health care industry may fear the possibility of arrest and detention, including in workplaces like hospitals, palliative care facilities and clinics.” 

AHHC joins other state hospice advocates in legal challenge to Special Focus Program The Association for Home and Hospice Care of North Carolina (AHHCNC); Press Release; 1/23/25The Association for Home and Hospice Care of North Carolina (AHHCNC) has joined a multi-state coalition of hospices and hospice associations in challenging the federal government's implementation of the Hospice Special Focus Program (SFP), deeming it unlawful and arbitrary. The challengers are seeking a preliminary injunction to halt the SFP, citing patient safety concerns, misrepresentation of compliance records, and jeopardized access to high-quality end-of-life care. Congress directed CMS to establish the SFP to enhance enforcement for noncompliance hospices, but the Final Rule includes unrelated measures, heavily relying on survey data and other information not related to hospices’ compliance with Medicare requirements. Tim Rogers, President and CEO of AHHCNC, states:  "The approach CMS uses disadvantages well-established hospices and ignores Congress’s intent." [Click on the title's link to continue reading.] 

The 2024 election and potential battle for the social safety netJAMA Health Forum; Sara N. Bleich, PhD; Benjamin D. Sommers, MD, PhD; Rita Hamad, MD, PhD; 1/25Federal safety net programs play a major role in providing nutrition assistance, health insurance, income support, and much more to tens of millions of people with low incomes, including children, parents, and adults with disabilities or chronic conditions. Trump’s return to office for a second term with a Republican-controlled Senate and House leaves the future of the US social safety net unclear. Clinicians and public health professionals should elevate and advance strong evidence about the positive effects of the social safety net and the likely harms that would ensue if access or benefits are reduced.

Policy priorities for the first 100 daysC-TAC press release; 1/20/25The first 100 days of the Trump Administration and 119th Congress offer a pivotal opportunity to enact bold policies that improve the quality of care for individuals with serious illness while reducing overall healthcare costs. By addressing key policy priorities, we can create a healthcare system that delivers better outcomes for patients and families. C-TAC calls on policymakers to act now to advance solutions in the following areas:

DEA unveils long-overdue special registration for telemedicine in proposed ruleThe National Law Review; by Marika Miller, Nathan A. Beaver of Foley & Lardner LLP; 1/21/25 In the final days of the Biden administration, the Drug Enforcement Administration (DEA) released a proposed rule that would allow practitioners with a Special Registration to prescribe Schedule III-V, and in limited circumstances Schedule II, controlled substances via telemedicine. Practitioners with a Special Registration would still need to obtain a DEA registration in each state where they prescribe or dispense controlled substances. However, the proposed rule establishes a limited, less expensive State Telemedicine Registration as an alternative to the traditional DEA registration. The proposed rule imposes several obligations on practitioners with Special Registrations when they prescribe controlled substances via telemedicine.  [Click on the title's link to continue reading.]

Medicare spending, insurance claim denials top concerns: KFF poll Modern Healthcare; by Hayley Desilva; 1/17/25 A majority of individuals, regardless of their political leanings, say the federal government needs to spend more on healthcare programs, according to a KFF Health Tracking Poll released Friday. The survey of 1,310 people earlier this month highlights several areas in healthcare where the public would like to see things done differently. The results were published three days before a new administration is set to take over in Washington, D.C. 

Public healthAlzheimer's and Dementia; Stephanie Frilling; 12/24A Medicare Voluntary Advance Directive Framework (Framework) would enable the creation, storage, and sharing of advance directive documents, ensuring end-of-life care appropriately honors the individual and their care wishes, while supporting healthcare teams and family members in making care decisions for their patients and loved ones. With Medicare enrollment reaching over 65 million beneficiaries in 2023, and Alzheimer's becoming one of the most expensive conditions - CMS policy makers have a growing responsibility to improve care quality at end-of-life. 

Medical schools report steep drop in enrollment of Black and Hispanic students after Supreme Court ruling STAT; by Usha Lee McFarling; 1/9/25Enrollment of Black and Hispanic students in medical schools dropped precipitously last year after the Supreme Court banned the consideration of race in admissions, according to data released Thursday by the Association of American Medical Colleges. The number of Black enrollees fell by 11.6% compared to last year, while the number of Hispanic enrollees decreased 10.8%. The numbers were even starker for Indigenous students; the number of American Indian or Alaska Natives dropped by 22.1%, while students who were Native Hawaiian or Pacific Islanders dropped by 4.3%. 

Here are new state healthcare laws taking effect in 2025Modern Healthcare;by Hayley Desilva;1/2/25 Providers and insurers in several states will have to grapple with health-related laws taking effect in 2025. Most of the legislation concerns reproductive care and insurance coverage. Here are some of the laws affecting healthcare this year. [States include Arkansas, California, Colorado, Delaware, Idaho, Illinois, Minnesota, New Jersey, Pensylvania, and Washington.]