Literature Review

What's keeping CFOs up at night? Becker's Hospital CFO Report; by Alan Condon; 2/14/25 As health system CFOs chart their course for 2025, they face an increasingly complex financial landscape marked by mounting labor costs, tightening margins, shifting payer dynamics and an evolving regulatory environment. ... [Several] CFOs recently joined the “Becker's CFO and Revenue Cycle Podcast” to discuss the trends they're watching most closely — and the strategies they're deploying to stay ahead. [Key items include the following: labor shortages (key theme); major investments in ambulatory care facilities; AI to support operations and service; physician partnerships; shift from fee for service to value-based care; clinical labor; malpractice litigation; growth of Medicare Advantage programs; staffing shortages; inflation; reimbursements; providing care to undersinsured patients; Medicaid supplemental funding programs; "disruptors' by private equity and "other nontraditional players"; uncertainty of federal and state regulation changes.]

This 1970s TV actor left his entire – surprisingly large – fortune to the state that made him world famous Celebrity Net Worth; by Paula Wilson; 2/12/25 When you pass away, what will be your legacy? ... For 1970s actor Jack Ward, greatness meant leaving behind a gift. A surprisingly large gift that would keep on giving for many years after he was gone, benefitting the people of the state that made him famous… and rich… In 1968, he began appearing as Steve McGarrett on the cop show, "Hawaii 5-0." The popular cop show ran for the next twelve years. ... By the time Jack died in 1998, they had given the [Hawaii Community Foundation] $750,000. ... [Among the foundation's recipients ...] Hospice Hawai'i and St. Francis Hospice have been bolstered by the Lord Fund, .... The stable annual support has helped hospice programs expand outreach and grief counseling services for island residents. 

Medicare's 2025 physician pay cut, explainedBecker's Hospital CFO Report; by Stefanie Asin; 2/5/25 As of Jan. 1, Medicare is paying physicians almost 3% less than last year for services provided to the country's 66 million Medicare patients. The decreased payments aren't a surprise or anything new, as CMS, by law, must keep physician payments budget neutral (cannot raise total Medicare spending by more than $20 million in a year). As a result, since 2020, Medicare has cut physician pay each year ... [Click on the title's link to continue reading these items.]

After 'code issue,' veterans no longer receive free care at UP hospice site MyUpNow.com, Houghton, MI; by Thomas Fournier; 2/5/25 For a veteran staying at hospice care facility, it's important family can visit, especially in rural areas. But what happens when their facility no longer qualifies as a hospice facility for the Veteran's Health Administration (VHA)? Omega House Executive Director Mike Lutz said he received a call from the local Veteran's Affairs (VA) office in Iron Mountain late December 2024 informing him that they would "no longer be servicing veterans at Omega House." ... Veterans who would usually receive a reimbursement through the VA for their hospice care would no longer be able to find that at Omega House, leaving them to get their care 100 miles away or more. 

Visiting Nurses Foundation awarded $132,000 in grant funding to Assured Hospice for comfort therapies in 2024 The Chronical, Centralia, WA; by The Chronicle; 1/22/25 The Visiting Nurses Foundation awarded $132,000 in grant funding to Assured Hospice in 2024 to deliver essential comfort therapies to end-of-life patients across Washington state, the foundation announced Wednesday. "Since the partnership began in 2002 with a $600 grant, the program has expanded significantly, reaching hundreds of patients and their families each year," the Visiting Nurses Foundation said in a news release. Comfort therapies — including acupuncture, massage, music therapy, guided imagery and animal-assisted therapy — are proven to reduce pain, foster relaxation and enhance overall quality of life, the news release stated.

CMS announces updated Medicaid eligibility standards for 2025 McKnights Senior Living; by Lois A. Bowers; 1/17/25 The Centers for Medicare & Medicaid Services on Friday released an informational bulletin with updated federal poverty level standards applied to eligibility criteria for Medicaid. The 2025 guidelines reflect a 2.9% price increase between calendar years 2023 and 2024, the agency said. For 2025, the poverty guideline in all states except Alaska and Hawaii is $15,650 for a one-person family/household and $21,150 for a two-person family/household. The 2025 standards for individuals dually eligible for Medicare and Medicaid: [Click on the title's link to continue reading.]

3 nurse specialties with highest, lowest pay Becker's Hospital Review; by Kelly Gooch; 1/13/25 From January through July 2024, staff registered nurses involved in direct patient care saw their median base pay increase by 2%, compared to 1.4% for those in indirect patient care. However, RNs involved in direct and indirect patient care were poised for annual increases of 3% to 4% to close out 2024. ... The survey includes six-month percentage change data from January through July 2024. It is based on data from more than 700 participating organizations, representing approximately 358,000 individuals across over 115 nursing roles, including RNs, nursing managers and licensed practical nurses. [Click on the title's link for this important data.]

U.S. health care spending reaches $4.9 trillion Hospice News; by Jim Parker; 12/20/24 The nation’s total health expenditures rose 7.5% to $4.9 trillion in 2023, a new analysis by the U.S. Centers for Medicare & Medicaid Services (CMS) found. This growth took place at a faster pace in 2023 than prior years. In 2022, health care spending rose at a rate of 4.6%. Total Medicare hospice spending accounted for $25.7 billion last year, according to a separate report from the Medicare Payment Advisory Commission (MedPAC). ... About 21% of U.S. health care spending in 2023 was via Medicare, with private insurance representing a 30% share. Medicaid accounted for 21%, and the remaining 10% were out-of-pocket costs. “Hospital care, physician and clinical services, and nursing care facilities and continuing care retirement communities, which collectively accounted for 33% of all out-of-pocket spending in 2023, were the main contributors to the faster growth in 2023,” CMS indicated.

MedPAC advises cutting home health payments by 7 percent, freezing hospice payments in ’26 McKnights Home Care; by Liza Berger; 12/16/24 The Medicare Payment Advisory Commission (MedPAC) on Friday issued draft recommendations that entail cutting payments to home health agencies by 7% and freezing hospice payments in 2026. The body, which advises Congress on Medicare payment issues, issued the same recommendations last year. Providers, once again, were not pleased. “The recent recommendations by MedPAC regarding Medicare home health and hospice policy are misguided and deeply troubling,” Steve Landers, MD, CEO of the National Alliance for Care at Home, said in a statement to McKnight’s Home Care Daily Pulse. “Medicare hospice spending has not kept up with labor inflation in the past five years and the typical length of stay and proportion of beneficiaries accessing hospice has stagnated. With respect to home health, the recommendation for drastic cuts is based on a flawed analysis of agency margins that fails to account for all payers and the true financial health of the home health system.”

CGS Administrators, LLC, did not reopen and recalculate most selected hospices’ caps for years prior to 2020 USA HHS Ofice of Inspector General (OIG), Washington, DC; issued 11/27/24, posted 12/4/24Why OIG Did This Audit: ... Our audit determined whether CGS accurately calculated cap amounts and collected cap overpayments in accordance with CMS requirements. This audit is part of a series that reviewed MAC calculations and collections of hospice aggregate and inpatient cap overpayments.What OID Recommends: [... that CGS] 

Michael Dowling: We've revolutionized care for aging adults, but is America's health system ready for the senior population boom? Becker's Hospital Review; by Michael J. Dowling, President and CEO, Northwell Health; 12/2/24 Like many baby boomers and those from earlier generations, I have vivid memories from my younger years of my grandparents and other aging adults struggling with an assortment of ailments that their doctors told them were just an inevitable part of growing old. ... The transformative advancements made over the past half-century in meeting the physical and emotional health needs of the nation's rapidly aging population are remarkable — and that's especially important because more Americans are turning age 65 now than in any other time in our history (4.1 million in 2024, or 11,200 a day). And as we move toward a new year, every healthcare executive must examine whether we are collectively prepared to care for them in the years and decades ahead and take steps to recruit the medical specialists we need to meet burgeoning demand. ... Lastly, all clinicians must embrace palliative care as part of their standard practice in managing the health of aging adults with serious illness. ... 

Seven of thirty hospices reviewed did not comply or may not have complied with terms and conditions and federal requirements for Provider Relief Fund payments HHS Office of Inspector General; issued on 11/8/24, posted on 11/14/24Why OIG Did This Audit: The Provider Relief Fund (PRF), a $178 billion program, provided funds to eligible providers for health care-related expenses or lost revenue attributable to COVID-19. ... This audit is part of a series reviewing PRF payments to various provider types. Specifically, this audit assessed whether 30 selected hospices expended taxpayer funds in accordance with Federal and program requirements. ... What OIG Found: ... Of the 30 selected hospices, 23 hospices used PRF funds for allowable expenditures and lost revenues attributable to COVID-19; however, 7 hospices did not comply with or may not have complied with Federal requirements. Of these seven hospices, which received $98.1 million in PRF payments, six hospices claimed a total of $8.3 million of unallowable PRF expenditures and inaccurately reported $1.5 million of lost revenues, and one hospice claimed $4 million in expenditures that may not have been allowable. ... What OIG Recommends: We made two recommendations to HRSA, including that it require the selected hospices to return any unallowable expenditures to the Federal Government or ensure that the hospices properly account for these expenditures. ...