Literature Review

Medicaid’s role in health and in the health care landscape: LDI expert insights and key takeaways from select publications Penn LDI - Leonard Davis Institute of Health Economics, Philadelphia, PA; by Julia Hinckley, JD; 3/17/25... Medicaid accounts for one-fifth of U.S. health care spending and covers more than a quarter of Americans. LDI researchers have examined the services it provides in supporting aging adults, people with disabilities, and children, as well as its role in health crises such as chronic disease and suicide. ... Below are select key findings from recent peer-reviewed research, along with expert insights for policymakers considering changes to Medicaid funding in the federal budget.

Oz does not rule out Medicaid cuts during Senate confirmation hearing McKnights Home Care; by Adam Healy; 3/14/25 Mehmet Oz, MD, President Donald Trump’s pick to lead the Centers for Medicare & Medicaid Services, did not give a direct answer when asked whether he was for or against Medicaid cuts Friday during a Senate Finance Committee hearing. “I cherish Medicaid and I’ve worked within the Medicaid environment quite extensively practicing at Columbia University,” Oz said when asked by Sen. Ron Wyden (D-OR) if he would oppose cuts to Medicaid. “I want to make sure that patients today and in the future have resources to protect them if they get ill. The way you protect Medicaid is by making sure it’s viable at every level, which includes having enough practitioners to afford the services, paying them enough to do what you request of them, and making sure that patients are able to actually use Medicaid.”

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.]

2 tailwinds shaping hospice growth, care delivery Hospice News; by Holly Vossel; 3/14/25 Rising demand for end-of-life care is pushing hospice growth opportunities to the forefront in value-based reimbursement. More payers in this arena are increasingly recognizing the depth of potential beneficial outcomes when it comes to collaborative hospice partnerships. Swelling aging populations have fueled rising health care costs across the country, with payers and providers alike seeking ways to ensure affordable access and sustainable services. ... “As far as tailwinds for the industry specific to hospice, [it’s] predictions for demographic growth,” [David Jackson, CEO and founding partner of Choice Health at Home] said. “The biggest opportunities for growth [are] talking about vertical integration and how we reach up into the health care system. [It’s] talking about the value that we bring from the perspective of patient care, and then talk about the plans, the payers, the opportunity to enhance their financial outcomes.”

Malpractice lawsuits are rising — here’s how physicians can protect themselves Becker's ASC Review; by Patsy Newitt; 3/11/25 Medical malpractice insurance is essential for protecting physicians from financial and legal risks, particularly amid the rise in malpractice lawsuits, according to a March 5 article on Physicians Thrive’s website.  In 2023, malpractice verdicts hit a record high. There were 57 medical malpractice verdicts of $10 million or more, with more than half of those verdicts hitting $25 million.  Here are nine things to know from the Physician’s Thrive article. 

[UK] 'Rising costs mean difficult decisions' - hospices BBC News, Somerset, UK; by Bea Swallow; 3/1/25 Hospice charities have warned "difficult decisions" could be on the horizon unless changes are made to "restrictive" government funding. On Wednesday, the government announced the release of £25 million for hospices across England, but this is reserved for facility upgrades and refurbishments only. ... Facing a "significant rise" in demand and costs, hospices across the country have been rallying for a more sustainable, long-term funding solution for the sector. ... Penny Agent, chief operating officer for Dorothy House, said unless it received support with staffing costs, it would have no choice but to cut back on services. 

House sets up potential Medicaid cuts with budget bill passage Modern Healthcare; by Michael McAliff; 2/25/25 Republicans in the House took the first step Tuesday [2/25] toward steep potential healthcare cuts, passing a budget resolution that aims to trim spending by at least $1.5 trillion while also adding trillions to the debt to fund tax cuts. The House voted 217-215 on nearly party lines to begin what is known as budget reconciliation, passing a budget resolution that instructs committees to come up with cuts or extend tax cuts that largely benefit the wealthy. The bill mandates the House Energy and Commerce Committee, which oversees Medicaid and Medicare, come up with the majority of the savings, and cut $880 billion.

Study shows end-of-life cancer care lacking for Medicare patients Vanderbilt University Medical Center (VUMC) News; by Tom Wilemon; 2/21/25 The study involved patients of diverse ethnic backgrounds age 66 or older who died from breast, prostate, pancreatic or lung cancers. Many Medicare patients with advanced cancer receive potentially aggressive treatment at the expense of supportive care, according to a study that analyzed Medicare records. The study, published Feb. 21 in JAMA Health Forum, examined the quality of end-of-life care among 33,744 Medicare decedents. ... Overall, claims records showed that 45% of the patients experienced potentially aggressive care (such as multiple acute care visits within days of death), while there was a low receipt of supportive care, such as palliative, hospice and advanced care planning in the last six months of life. While hospice care spiked to more than 70% during the month that death occurred, over 16% of patients spent less than 3 days in hospices. Moreover, receipt of advanced care planning and palliative care remained below 25%. Editor's note: Click here for the research article, "Contemporary Patterns of End-of-Life Care Among Medicare Beneficiaries With Advanced Cancer." Though this research was published just this past Friday February 21, 2025, multiple newsletters are posting it, highlighting different elements. 

Ascension recoups $1B in advance payments Becker's Hospital CFO Report; by Alan Condon; 2/19/25 St. Louis-based Ascension has recouped about $1 billion in advance payments from Medicare and certain commercial payers related to disruptions from the May ransomware attack that affected the health system as well as the February 2024 Change Healthcare cyberattack. "The advance payments helped to mitigate the unfavorable cash flow impacts associated with the aforementioned cyber incidents as revenue cycle processes continue to ramp towards recovery," the health system said in financial documents published Feb. 17. "In accordance with the terms and conditions of the programs, recoupments began in FY24 with all payments being fully recouped at Dec. 31, 2024." 

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.