Literature Review

HHS proposal slashes Medicare SHIP funds MSN; by Mary Helen Gillespie; 4/22/25 The Trump administration is proposing federal budget cuts to Medicare State Health Insurance Assistance Programs (SHIP) and seven additional elder health care safety net programs that assist older Americans. ... SHIP programs have been under the umbrella of the Health and Human Services agency Administration for Community Living. The pre-decisional budget lists funds for seven other ACL programs that would be eliminated are:

Access to hospice and certain services under the hospice benefit for beneficiaries with end-stage renal disease and beneficiaries with cancer MedPAC; by Kim Nueman, Grace Oh, and Nancy Ray; 4/11/25 [From MedPac Presentation Roadmap, Meetings held April 10 & 11, 2025]

CMS drops 5 proposed payment rules for 2026: 25 things to knowBecker's Hospital Review; by Alan Condon; 4/11/25 CMS has released proposed payment rules for inpatient and long-term care hospitals, hospices and inpatient rehabilitation, psychiatric and skilled nursing facilities in fiscal year 2026. Twenty-five things to know: ...

The cost of nurse turnover in 24 numbers | 2025 Becker's Hospital Review; by Molly Gamble; 4/7/25 Nurse shortages and mounting labor costs are among health system CEOs’ top concerns, and a new survey puts numbers to the financial risks hospitals face from nurse vacancies and churn. The 2025 NSI National Health Care Retention & RN Staffing Report features input from 450 hospitals in 37 states on registered nurse turnover, retention, vacancy rates, recruitment metrics and staffing strategies.  It found the average cost of turnover for one staff RN grew from January through December 2024 to $61,110, among other dollar figures and statistics that are helpful to understand the financial implications of one of healthcare’s most persistent labor disruptions. Here are 24 numbers that illustrate the cost of nurse turnover, according to the most recent edition of the report, which is available in full here. [Continue reading ...]

How this thrift shop helps Virginia families in their time of need: 'They’re good people here' CBS-6 News - Richmond, Petersburg, VA; by Wayne Covil; 3/31/25 The regulars who frequent Crater Community Hospice Thrift Shops were busy browsing for bargains on Monday. They know that some of the money they spend here goes back into their community. Crater Community Hospice runs the stores as a way for the nonprofit to raise much-needed funding. "The money we bring in to our stores goes directly to caring for our patients," Zach Holt, with Crater Community Hospice, said. "I don’t want to ever say no to a patient. I don’t want to ever say no to a patient’s need." Krystal Mansfield told CBS 6 there was a reason she chose to shop at Crater Community Hospice Thrift Shops. "[It] was a big part of my grandmother's end of time, and they took very good care of her in her last days," Mansfield said. ... Angie Dowdy shared a similar story. ... [Continue reading ...]

Medicare Administrative Contractors [MACs] did not consistently meet Medicare Cost Report Oversight Requirements HHS-OIG; Issued on 3/18/25, posted on 3/19/25 ... What OIG Found: MACs did not consistently meet Medicare cost report oversight requirements.

Evaluation of the Medicare Advantage Value-Based Insurance Design model test: 2020 to 2023  RAND Health Care, prepared for the Centers for Medicare & Medicaid Services Center for Medicare and Medicaid Innovation Under Research, Measurement, Assessment, Design, and Analysis Contract Number 75FCMC19D0093, Order Number 75FCMC20F0001; by Christine Eibner, Dmitry Khodyakov, Erin A. Taylor, Denis Agniel, Rebecca Anhang Price, Julia Bandini, Marika Booth, Lane F. Burgette, Christine Buttorff, Catherine C. Cohen, Stephanie Dellva, Michael Dworsky, Natalie C. Ernecoff, Alice Y. Kim, Julie Lai, Monique Martineau, Nabeel Qureshi, Afshin Rastegar, Max Rubinstein, Daniel Schwam, Joan M. Teno, Anagha Tolpadi, Shiyuan Zhang; March 2025 This report presents RAND researchers’ findings from their evaluation of the Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model test for 2020 through 2023, initiated by the Center for Medicare and Medicaid Innovation (Innovation Center). The VBID Model allows participating MA parent organizations (POs) to offer supplemental benefits, financial and nonfinancial incentives to beneficiaries, hospice benefits (the Medicare Hospice Benefit, Palliative Care, Transitional Concurrent Care, and Hospice Supplemental Benefits), and Wellness and Health Care Planning through their MA plans.

Charting the path forward to Value-Based Care Forbes; by David Snow, Jr.; 3/25/25 The U.S. healthcare system is at a crossroads, embarking on a crucial transformation in how care is financed. For decades, we've operated under a fee-for-service (FFS) model, which incentivizes service volume with little accountability for efficacy or costs. According to the Commonwealth Fund, this model contributes to poor healthcare access, lower care quality and lack of care continuity and is a factor behind the staggering per-capita healthcare costs in the U.S., which are the highest in the world. ... In recent years, we've seen a shift away from the FFS model to progressive value-based care (VBC) models that link provider payments to patient outcomes, care quality and cost efficiency. This is a fundamental overhaul of healthcare economics, and although it may be challenging and disruptive, I believe it's essential. [Continue reading ...]

From heroes to burnout: How we failed our frontline health workers MedPage Today's KevinMD.com, and excerpt from Health Care Nation; by Tom Lawry; 3/15/25 Of all the lessons learned from fighting a pandemic, none was more frightening or important than discovering how dependent the system is on how we treat our doctors, nurses, and frontline caregivers.  They were already in short supply, with burnout on the rise, when the pandemic hit. As multiple waves of COVID-19 variants washed over us, frontline health workers stepped in at great risk and personal sacrifice to care for highly infectious patients. ... Some witnessed more deaths on a double shift than they did in a normal year. They delivered the bad news to families and managed end-of-life care. They were often the last face and warm voice a COVID-19 victim saw and heard. In the end, they not only saved lives but saved the system from total collapse. ... We called them heroes. And we promised to do better in how we treated them once the COVID-19 crisis passed. Promises made should be promises kept. While we continue to talk about workforce burnout using polite terms with concern in our voices, let us be clear: A system with a mission of healing continues to harm in record numbers the very people in short supply who are there to take care of the rest of us. ... [Click on the title's link for more.]

The challenges ahead with Jeanne Chiricohallenges ahead with Jeanne Chirico, HPCANYS President/CEO

MedPAC recommends Congress tie physician pay to inflation for 2026 Healthcare Dive; by Susanna Vogel; 3/17/25 Dive Brief:

Medicare Payment Advisory Commission [MedPAC] releases report to Congress on Medicare Payment Policy 2025 report on Medicare payment policy Medicare Payment Advisory Commission, Washington, DC; News Release, contact Stephanie Cameron; 3/13/25Today [3/13/25], the Medicare Payment Advisory Commission (MedPAC) eleases its March 2025 Report to the Congress: Medicare Payment Policy. The report presents MedPAC’s recommendations for updating provider payment rates in fee-for-service (FFS) Medicare for 2026, providing additional resources to acute care hospitals and clinicians who furnish care to Medicare beneficiaries with low incomes, and eliminating certain Medicare coverage limits on stays in freestanding inpatient psychiatric facilities. The report reviews the status of ambulatory surgical centers (ASCs), the Medicare Advantage (MA) program (Medicare Part C), and the Part D prescription drug program (Medicare Part D). ... Fee-for-service payment rate update recommendations. ... MedPAC recommends ... payment reductions relative to current law for hospice providers, skilled nursing facilities, home health agencies, and inpatient rehabilitation facilities.  [Click on the title's link to continue reading.]

Less wealth at death linked to more end-of-life symptoms McKnights Long-Term Care News; by Kristen Fischer; 3/10/25 Older people with less wealth showed a higher burden of symptoms when they approached the end of their lives compared with those who had more wealth, a study found. The report was published in JAMA Network Open on March 6. Investigators looked at data from 8,976 older adults. The team evaluated 12 end-of-life symptoms including difficulty breathing, frequent vomiting, low appetite, difficulty controlling arms and legs, depression, and severe fatigue or exhaustion.Then they correlated symptoms to individuals’ wealth. Wealth was broken into three categories: low wealth was having less than $6,000; medium wealth was having between $6,000 and $120,000; and high wealth was considered having more than $120,000 at the time of death. Of respondents, 22.5% had low wealth, 50.5% had medium wealth and 27.1% had higher wealth. People who had less wealth were more likely to have a higher burden of symptoms compared to those who had more money. Functional impairment, multimorbidity and dementia were factors that affected the association, data revealed.Editor's note: Click here for this important JAMA article, posted in our Saturday Research issue 3/15/25, "Wealth disparities in end-of-life symptom burden among older adults."