Literature Review

Simmons Nursing and Dix Scholar Alum offers palliative care to Navajo nation Simmons University, Boston, MA; 11/20/24 Susan Perron ’18 came to Simmons as an adult student, pursuing her second bachelor’s degree. “I wanted a job that used both practical and critical thinking skills,” says Perron. “I wanted to do something helpful to humanity.”  ...  “I was a COVID-19 nurse throughout the pandemic, and it burned me out,” she recalls. “If you’re a good nurse, you take time to self-reflect. ... Perron took the opportunity and moved to the Hopi Reservation in Northeastern Arizona. Providing ambulatory care to people on the reservation meant that Perron could work in a clinic and take a break from twelve-hour shifts. That said, the year on the Hopi Reservation presented her with challenges. “I had to drive two hours to Flagstaff to get groceries. We would lose power often, and the water was often shut off for maintenance." ... Perron emphasizes that understanding the Navajo belief system is integral to this kind of work. In addition to Dr. Mohs, Perron works closely with her colleague and mentor, Ida Bradley (Navajo) a nurse who specializes in medical terminology in the Navajo language and has extensive experience with end of life care within the Navajo culture. 

Hospice of Northwest Ohio will operate ProMedica's palliative care services CBS WTOL 11, Toledo, OH; by Karmann Ludwig; 11/18/24 Hospice of Northwest Ohio will operate ProMedica's palliative care services at the start of next year, according to a press release from Hospice released Monday. The company said ProMedica's patients who remain in palliative care will be transferred to Sincera Supportive Care and Symptom Relief, one of Hospice of Northwest Ohio's services. Sincera will also take over responsibility for ProMedica's palliative care outpatient clinics, Hospice of Northwest Ohio said. 

Growing palliative care team expands access into ambulatory setting UConn Today; by Jennifer Walker; 11/13/24 Palliative care is a medical subspecialty focused on providing relief from the symptoms and stress of serious illness. The goal is to improve the quality of life for both the patient and the family. Palliative care is appropriate at any age and stage of illness and can be provided along with all other medical treatments. Eight years ago, UConn Health began outpatient palliative care at the Carole and Ray Neag Comprehensive Cancer Center with a cancer center supportive care clinic.  The supportive care clinic includes two full-time nurse practitioners and support from an interdisciplinary team. The service has continued to grow since it was started with volumes increasing 250%. As the Cancer Center grows, volume and need for palliative care is also anticipated to increase.

How health system palliative providers can leverage data to gain more resources Hospice News; by Jim Parker; 11/12/24 Palliative care clinicians in health systems can apply research to lobby administrators for additional resources. In doing so, they may get a profile boost due to the COVID-19 pandemic. Palliative care’s reputation grew during the pandemic, with more patients and health care organizations recognizing its benefits and value. Stakeholders can leverage this in discussions with organization leaders, according to Dr. Tamara Vesel, chief of the Palliative Care Division at Tufts Medical Center and associate professor of medicine and pediatrics, Tufts University School of Medicine. ... When approaching organization leaders to advocate for palliative care, the importance of data cannot be overstated, according to study co-author Dr. Bernice Burkarth, chief medical officer of Tufts Medicine Care at Home and assistant professor of medicine at Tufts University School of Medicine.Editor's note: Reminder, our newsletter's Saturday edition always compiles relevant, timely research articles for you. To me, the word "research" means to "re-search," as in to search again--now--for the best information and appliciations available, today. We do alot of the work for you, re-searching and re-searching topics, pairing timely hospice and palliative challenges with formal research's background needs, research methods, data, references, conclusions, applications, and needs for further examination. 

CMS finalizes 2.9% cut in physician payments for 2025, including for palliative care Hospice News; by Jim Parker; 11/4/24 The U.S. Centers for Medicare & Medicaid Services (CMS) has finalized a nearly 2.9% cut for 2025 in physician payment rates used to reimburse palliative care care practitioners, among other professionals. The final rule also states that the telehealth flexibilities implemented during the COVID-19 public health emergency will expire at the end of this year unless Congress intervenes. Physicians and other professionals will have to follow pre-COVID restrictions on telehealth, with few exceptions. Industry organizations were quick to denounce the pay cut. “To put it bluntly, Medicare plans to pay us less while costs go up. You don’t have to be an economist to know that is an unsustainable trend, though one that has been going on for decades,” American Medical Association President Dr. Bruce Scott said in a statement.

Palliative care in the ED reduces costs, improves patient outcomes Hospice News; by Jim Parker; 10/28/24 The presence of an embedded palliative care practitioner in the emergency department can significantly improve patient outcomes and reduce costs. A pilot program at the Michigan-based Corewell Health system in which a palliative physician was embedded in the ED effectively reduced inpatient mortality, readmissions, intensive care unit utilization and the total cost of care, while also boosting staff satisfaction, Lisa VanderWel, senior director for Corewell Health Hospice and Palliative Care, said during a presentation at the National Hospice and Palliative Care Organization (NHPCO) Annual Leadership Conference in Denver. ... “When you do really good palliative care, what happens?” she said during the presentation. “You have those [goals-of-care] conversations in a more timely manner. You have an earlier conversion to hospice. You avoid all the stress and crisis that’s involved if you wait until the last minute.”

Customizing a palliative program to patient, payer priorities Hospice News; by Jim Parker; 10/23/24 While some palliative care programs mirror the hospice model, more operators are working to tailor their services to patients’ specific needs, with varying intensity. This is increasingly important as payment shifts towards value-based payment models in which demonstrating cost savings is crucial to success. Providers need to demonstrate strong performance on quality scores as well as a track record of effectively preventing avoidable hospitalizations, readmissions and emergency department visits. This is particularly the case when negotiating contracts with Medicare Advantage plans, Accountable Care Organizations (ACOs) and other value-based payment arrangements, Sue Lynn Schramm, a partner of the hospice and palliative care consulting company Confidis, LLC, said in a presentation at the National Hospice and Palliative Care Organization Annual Leadership Conference. [Click on the title's link to continue reading.]

Clinic combines ILD, palliative care to improve access for underserved patients Healio; by Richard Gawel; 10/18/24 Boston, MA - A subspeciality clinic that combined pulmonary and palliative care improved access to these treatments for diverse and underserved populations, according to an abstract presented at the CHEST Annual Meeting. The clinic also was effective in supporting patients as they completed advanced care planning, compared with a clinic for interstitial lung disease, Meghan Price, MD, internal medicine resident, Johns Hopkins Hospital, and colleagues wrote. ... Rebecca Anna Gersten, MD, assistant professor of medicine, established the Breathlessness Clinic (BC) in 2022 to provide both pulmonary and palliative care to treat patients with significant dyspnea and other symptoms due to their advanced lung disease. The clinic aims to provide targeted management of symptoms in addition to improving access to palliative care for patients who may have encountered obstacles in accessing palliative care, the researchers said.

Stratis Health builds framework for expanding rural community-based palliative care Hospice News; by Jim Parker; 10/16/24 The health care performance improvement company Stratis Health has developed a framework for expanding access to palliative care in rural communities. The company’s strategy convenes resources and organizations that already exist in a given community to help meet patient’s palliative care, psychosocial, spiritual and social determinants of health needs. It leverages those resources to offer a wraparound suite of services for seniors and seriously ill patients. Hospice News spoke with Karla Weng, senior program manager for Stratis Health, about how health care providers and other stakeholders serving rural communities can come together to better serve their patients and clients. ... The field has shifted in more recent years, so that community-based really means anywhere but the hospital. It might be in a clinic. It might be home care. We’re not that prescriptive. So we have sometimes shifted to using the language “community centric.” The way that we work with communities who are interested in going down this path is helping them first to do a gap analysis and assessment of the resources that are already there in their community.  ... [Click on the title's link to continue reading.]

Palliative care use low in patients with heart failure in the United States Cardiology Advisor; by Ron Goldberg; 10/10/24 Palliative care (PC) use for end-of-life care in heart failure (HF) in the United States is low, with geographic and racial variations in access and application, and PC is becoming necessary for younger, healthier patients seeking a better quality of life, according to study findings published in the Journal of the American Heart Association. ... "PC for HF remains low in the United States. Racial and geographic variations in access and use of PC exist for patients with HF,” the investigators concluded. “These findings suggest that palliative care is not only an end-of-life care for older patients with HF but can be necessary for younger, healthier patients with needs for advanced therapies and for better quality of life.”

How poor health literacy can diminish access to palliative care Hospice News; by Jim Parker; 10/11/24 Low health literacy among seriously ill patients can impede access to palliative care and complicate efforts to improve health equity. Health literacy is the degree to which individuals can obtain, process and understand basic health information and services needed to make appropriate health decisions, according to the Institute of Medicine. A health illiterate patient may have a strong overall ability to read or have an advanced education but have a limited understanding of information specific to health care. ... The issue deepens when it comes to palliative care. An estimated 71% of adults in the United States are unaware that palliative care exists, studies have shown, even though nearly 80% of consumers who received background information on palliative care say they would choose it for themselves or their loved ones. 

The best bets for palliative care reimbursement post-VBID Hospice News; by Jim Parker; 10/8/24 The hospice component of the value-based insurance design model (VBID) will sunset at the end of this year, but opportunities for payment through Medicare Advantage and other models remain. The hospice component is part of the larger VBID program, which will continue through 2030. The component was designed to test coverage of hospice through Medicare Advantage. It also contained elements intended to expand access to palliative care, for which reimbursement in general is scarce. Hospice News spoke with Dr. Bob Parker, chief clinical officer and chief compliance officer for the Texas-based hospice provider Kindful Health, about the opportunities in place for palliative care providers. [Click on the title's link for this interview.]

New coalition launches to advance palliative cancer care Hospice News; by Jim Parker; 9/30/24 A new organization, Together for Supportive Cancer Care, launched Monday with a mission to expand access to palliative care among cancer patients. A charitable group, The Sheri and Les Biller Family Foundation, convened more than 40 member organizations, including health care providers, pharmaceutical companies, patient advocacy groups, public policy experts, employers and insurers, among others. “For decades, leaders around our country have worked to show the promise and impact of supportive care programs for people living with cancer, their caregivers and their loved ones,” said Audrey Haberman, the foundation’s CEO, in a statement. “The launch of Together for Supportive Cancer Care builds on this work and is an important step toward creating a health care system where early and ongoing access to supportive care is not a privilege, but a fundamental part of the cancer journey for everyone.”