Literature Review

Families demand end to Medicare waiting period for early-onset Alzheimer’s patients Washington Examiner; by Elaine Mallon; 6/15/25 Jason Raubach was diagnosed at 50 years old with early-onset Alzheimer’s disease — a diagnosis that affects nearly 200,000 Americans. He received the diagnosis in 2018, completely upending life for his family. His youngest child was just a freshman in high school. ... Shortly before receiving an official diagnosis, Jason Raubach lost his job, having to move his family onto a consolidated omnibus budget reconciliation act health plan, or COBRA plan, which allows a person to keep their health insurance even after losing their job. “It wasn’t cheap,” Elizabeth Raubach said.However, once diagnosed, Jason Raubach had to wait two and a half years before he could receive coverage under Medicare, health insurance for those 65 years and older or those with qualifying disabilities. But Elizabeth Raubach, along with dozens of other caretakers for people diagnosed with Alzheimer’s, called on Congress in a letter to eliminate the 29-month waiting period required for those under the age of 65 to receive coverage under Medicare. ...

National Alliance: Proposed 2.4% hospice payment update would create shortfall Hospice News; by Jim Parker; 6/11/25 The U.S. Centers for Medicare & Medicaid Services’ (CMS) proposed 2.4% hospice base rate increase is woefully inadequate, and new physician attestation requirements may place undue burdens on providers, according to comments from the National Alliance for Care at Home. The Alliance on Tuesday released its public comments on the 2026 hospice payment rule, which stated that the proposed increase will not adequately cover hospices’ rising costs for supplies, labor, travel and other expenses. 

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.

TCN/HPC Today: Storm clouds on the horizon for reimbursement - Top news stories, May 2025 Teleios Collaborative Network (TCN); podcast by Chris Comeaux with Cordt Kassner, 6/4/25 What happens when artificial intelligence meets end-of-life care?  How do we reconcile private equity's profit motives with hospice's mission-driven ethos?  These questions took center stage in this month's roundup of hospice news with host Chris Comeaux and guest Cordt Kassner. The May edition of TCNtalks' top news stories reveals a healthcare sector at a fascinating crossroads.  AI has emerged as both a tantalizing promise and a practical challenge for hospice providers.  ... In this episode of TCN Talks, hosts Chris Comeaux and Cord Kassner reflect on Memorial Day and discuss significant news stories from May, including the complexities of thanking veterans for their service, the role of artificial intelligence in hospice care, and the importance of honest conversations about racism in healthcare.Editor's note: This monthly podcast combines quantitative data and qualitative discussion from articles gleaned from the 400+ posts we provide each month. Do you seek to make sense of it all? Tune in and learn. We welcome your feedback via our newsletter's Contact page. 

Saugus nurse arrested in FBI raid for alleged part in $2.5 million Medicare [hospice] fraud KHTS - Santa Clarita News, Santa Clarita, CA; by Jade Aubuchon; 5/30/25 Jessa Zayas, aka Jessa Contreras, a vocational nurse, is believed to have committed medicare fraud through two different hospice providers, submitting more than $2,500,000 in fraudulent claims to Medicare. Zayas is the Chief Executive Officer of two hospice providers, Healing Hands Hospice Inc. and Humane Love Hospice. From June 2023 through February 2025, she caused Healing Hands and Humane Love to bill Medicare for millions of dollars’ worth of hospice services that were not medically necessary, not authorized by a physician, and were not actually provided to the patients. ...

SpiriTrust Lutheran says Home Care & Hospice operations will wind down across three counties, end service on July 18th Tri-State Alert, Chambersburg, PA; Press Release; 5/29/25 Earlier on Thursday [5/29], News Talk 1037FM was alerted to a WARN notice from SpiriTrust Lutheran as to a closure of a portion of their business. Throughout the process, that notice has been narrowed down to their Home Care & Hospice (HCH), with the company announcing their plans to discontinue operations out of their Franklin County office which serves clients in Franklin, Adams and York counties. The official closure will be July 18, 2025. ... SpiriTrust Lutheran says that roughly 65 home care and hospice employees will be affected by the shutting, but  some are expected to be reassigned or offered positions within the SpiriTrust Lutheran family of Life Plan Communities ... SpiriTrust Lutheran officials cited the organization’s ongoing challenges mirrored those confronting many similar organizations nationwide – significant increases in the cost of delivering care due to staffing shortages; rising benefit expenses; and the escalating prices for medical supplies and pharmacy. 

Empath Health to sell service center location Hospice News; by Jim Parker; 5/29/25  The Florida-based senior care provider Empath Health is selling one of its administrative service centers, located in Pinellas County in its home state. The center was initially established by Suncoast Hospice, which is now an Empath Health affiliate. The sale is part of Empath’s effort to “realign its physical footprint” to invent more directly in home-based, patient-centered care, according to a statement from the organization. “Selling an underutilized administrative building allows us to reinvest in the people, programs and technology that bring comfort, dignity, and support into homes and communities,” said Jonathan Fleece, president and CEO of Empath Health, in the statement. “It’s a return to our roots and a recommitment to the future.”

Proposed California budget calls for prior authorization for hospice in Medicaid Hospice News; by Jim Parker; 5/22/25 The proposed California budget would require prior authorizations for hospice care within the state’s Medicaid program. Currently, Medicaid managed care plans who provide coverage through the state’s Medicaid system, Medi-Cal, may not perform prior authorizations for hospice. California’s Department of Health Care Services (DHCS) indicated in a 2025-2026 budget revision that this could save $25 million over the next two years and more than $50 million in the long term. If enacted, this would make California the first state in the nation to implement such a rule, according to the California Hospice & Palliative Care Association (CHAPCA). The association contends that the anticipated $25 million in cost savings is “speculative and fails to account for the downstream costs and systemic burdens this proposal would create,” according to a position paper shared with Hospice News. ... CHAPCA recommended to the state government three alternative approaches: ...

Proposed bill would require MA to pay for hospice care Hospice News; by Jim Parker; 5/21/25 Rep. David Schweikert (R-Ariz.) has introduced the Medicare Advantage Reform Act, which among other provisions would require health plans to pay for hospice care. If enacted, the bill, numbered H.R. 3467, would make wholesale changes to the Medicare Advantage program. It would mandate capitated payment models, change risk adjustment methodologies and create new exemptions for physician self-referrals, among other provisions. The potential impacts of moving hospice into Medicare Advantage at this time would be “devastating,” according to the National Alliance for Care at Home. 

[Commentary] It’s time to bring value-based care principles to hospice Medical Economics; by Asher Perzigian; 5/20/25 In the health care industry, the conversation around value-based care (VBC) has been abuzz for a while now. The idea is simple: pay for outcomes, not for services, and shift our mindset from volume to value as we reduce unnecessary care, improve outcomes and bend the cost curve. However, when we talk about VBC, we often overlook a critical part of the health care continuum: hospice care. And when it comes to end-of-life care, traditional measures like survival rates and reduced readmissions lose their relevance. Hospice embodies some of the deepest principles of VBC: aligning care with patient goals, avoiding unneeded interventions and supporting the person as a whole. Here’s what primary care physicians need to know about the integration of value-based principles in hospice care. 

Addressing workforce challenges: Hospice in the news, April 2025 Teleios Collaborative Network (TCN); podcast by Chris Comeaux with Cordt Kassner; 5/7/25 What defines quality in end-of-life care?  How are Hospice organizations navigating workforce challenges?  And why has medical aid in dying become such a critical conversation?  These questions take center stage in this data-driven exploration of April's most impactful Hospice and Palliative Care news stories. In this episode of TCNtalks, Chris Comeaux and Cordt Kassner discuss the top news stories from April, focusing on Hospice and Palliative Care.  They explore personal aspirations, data insights, the impact of spiritual care, emerging categories in news reporting, and key themes such as reimbursement and workforce challenges.  The conversation also touches on mission moments, regulatory changes, technology innovations, and the evolving nature of leadership in healthcare, particularly in the context of AI and human skills. ... Cordt closes the show with a Master's Class reviewing the National Hospice Locator, a valuable tool for finding high-quality Hospice Care anywhere in the country.

American Oncology Network achieves success in first performance period of CMMI’s enhancing oncology model Stock Titan, Globe Newswire, Fort Myers, FL; 4/22/25 American Oncology Network (AON), one of the nation’s fastest-growing community oncology networks, today announced strong results from the first performance period in the Centers for Medicare & Medicaid Innovation’s (CMMI) Enhancing Oncology Model (EOM). AON practices participating in the program—in collaboration with value-based cancer care enabler Thyme Care—achieved nearly $6M in cost savings for the Centers for Medicare & Medicaid Services (CMS). AON also earned a performance-based payment while improving patient experience and outcomes.

8 health system CEOs on the turbulence defining 2025 Becker's Hospital Review; by Kelly Gooch and Kristin Kuchno; 4/16/25 From capacity constraints to reimbursement pressures, health system CEOs are navigating a changing healthcare landscape. One of the top concerns in 2025 is the potential for Medicaid funding cuts. A recent report estimates hospitals could face a $31.9 billion loss in revenue if federal proposals to scale back Medicaid expansion move forward. CEOs from across the country — including safety-net systems, academic medical centers and expanding regional providers — recently shared how they are preparing for continued uncertainty and what strategies they are prioritizing in response.