Literature Review

How palliative care-ACO partnerships could reduce health disparities Hospice News; by Holly Vossel; 9/18/24 Palliative care providers engaging in Accountable Care Organization (ACO) relationships have the potential to make significant strides in bridging inequitable gaps of access. Groups of physicians, hospitals and other health care providers voluntarily join forces in ACOs, which are designed to offer high-quality, coordinated care to Medicare patients. Collaborating or contracting with ACO networks can help palliative care providers better understand and address the leading barriers among underserved populations as they move across the continuum, said Empath Health CEO Jonathan Fleece. The ACO reimbursement landscape includes incentives and quality measures designed to improve outcomes based on population needs. Providing palliative care through ACO relationships can result in greater potential to address patients’ full scope of medical, non-medical and psychosocial needs further upstream in their illness trajectories, Fleece stated, speaking at the recent Hospice News Palliative Care Virtual Summit.

[UK] End-of-life care demand for dementia patients set to surge, study warns Jersey Evening Post, United Kingdom; by UK News; 9/16/24 The number of people living with dementia who require end-of-life care is set to “substantially increase” in the coming years, according to a study. ... Researchers said: “Previous projections of the number of people with dementia who will have palliative care needs in England and Wales were based only on the number of people who died with dementia, and did not take into account people living with dementia. Thus, it is likely that the prevalence of palliative care needs among people with dementia in England and Wales has been considerably underestimated. Our analysis shows that even if dementia incidence declines between 2018 and 2040, the number of people living with dementia in England and Wales who have palliative care needs will increase substantially by 2040, reaching levels far greater than previous estimates based on mortality data.”Editor's note: How do these projection processes in the UK compare or contrast with the USA data you use? For more immediate information about current resources, click here for the Alzheimer's Assocation "Support for People Living With Dementia" and click here for 

The ‘Holy Grail’ of palliative care payment through ACOs Hospice News; by Jim Parker; 9/11/24 As opportunities to provide palliative care through Accountable Care Organization (ACO) relationships continue to arise, operators will likely need to understand the varying types of reimbursement that exist in that arena. ACOs are groups of physicians, hospitals and other health care providers who come together voluntarily to give coordinated high-quality care to their Medicare patients. Hospices and palliative care providers can collaborate with ACOs by becoming members of those organizations themselves, or by contracting with them through a preferred provider network. Community-based palliative care’s track record of reducing costs and hospitalizations could make providers of those services attractive to ACOs, according to Edo Banach, partner at Manatt Health, a division of the law firm Manatt, Phelps & Phillips, LLP.

Living your best life means embracing the last years, too UCSF - The University of California - San Francisco; by Suzanne Leigh; 9/9/24 UC San Francisco is working with nonprofits that serve seniors and patients with serious medical conditions to raise awareness about palliative care and advance care planning. The partnerships are the result of a collaboration between the UCSF Division of Palliative Medicine and the San Francisco Palliative Care Work Group (PCWG), which is working to address inequities among communities of color in accessing palliative care and advance care planning.

ASCO palliative care expert panel provides recommendations to integrate health equity into guideline development OncLive, Cranbury, NJ; by Kyle Doherty; 9/4/24 The ASCO Palliative Care Expert Panel [American Society of Clinical Oncology], in collaboration with ASCO’s Health Equity and Outcomes Committee, has published recommendations for integrating health equity measures into future guideline updates. Recommendations advocated for partnerships with increased representation from historically marginalized groups and patient and community-based advocates; a reinforcement of implicit bias training for Expert Panel members as a component of guideline preparation; stratified recommendations and/or guidelines for additional groups; and the review and appraisal of future recommendations by the Expert Panel, patient as well as community advocates, and ASCO reviewers for the inclusion of proper health equity measures before publication.

Bringing palliative care into the light to better serve patientsHospice News; by Jim Parker; 8/30/24For many medical providers across the country, palliative care services can be an unknown option for several patients and their families. A few reasons for that are a lack of awareness surrounding the benefits of palliative care, as well as the misconceptions about what this type of care offers for patients. As such, the model can go underutilized for those who could benefit from it the most. Cathy Wozniak is the executive director of Hospice & Palliative Care of Martha’s Vineyard in Massachusetts (HPCMV). Alongside the organization’s medical director, Dr. Lisa Vieira, she shared recent statistics, showcasing just how imperative palliative care options can be for many Americans.

New ASCO Guidelines stress importance of early palliative care Hospice News; by Jim Parker; 8/26/24 The 2024 update to the American Society of Clinical Oncology’s (ASCO) clinical practice guidelines place renewed emphasis on palliative care. The guidelines are updated periodically by a multidisciplinary team, including a patient representative and experts in medical and radiation oncology, hematology and palliative care. For the 2024 revisions, this panel reviewed 52 randomized controlled trials that evaluated outcomes among cancer patients who received palliative care, ASCO reported. “This is a pivotal time,” the panel’s co-chair Betty Ferrell of City of Hope Cancer Care told the ASCO Post. “This guideline is a call to action for everyone to think about how they are integrating palliative care for all patients with cancer. There are great advances in cancer care, but none of these will be fully effective unless we fully integrate palliative care.”

Cancer treatment 101: A primer for non-oncologists Medscape; by George D. Lundberg, MD; 8/22/24 Each year in the United States, approximately 1.7 million Americans are diagnosed with a potentially lethal malignancy. Typical therapies of choice include surgery, radiation, and occasionally, toxic chemotherapy (chemo) — approaches that eliminate the cancer in about 1,000,000 of these cases. The remaining 700,000 or so often proceed to chemotherapy either immediately or upon cancer recurrence, spread, or newly recognized metastases. ... I'm speaking in generalities, understanding that each cancer and each patient is unique. [Dr. Lundberg summarizes in user-friendly language:]

From fear to empowerment: How palliative care can help University of Utah Huntsman Cancer Institute; 8/21/24 In 2018, Ruth Hill got out of bed one morning and felt her spine literally break. The 53-year-old collapsed to the floor. “I knew something catastrophic had happened,” Ruth says. She soon learned six of her vertebrae had cracked and two had exploded. The doctor at the hospital in Colorado Springs, where Ruth had been visiting her son and grandchildren, gave her even more devastating news. “You’re filled with cancer. It’s incurable,” he told her. “We’re going to take you upstairs and check your brain. If it’s in your brain, you won’t have long to live.” ... [Click on the title's link to continue reading this inspirational story.]

Capitalizing palliative care startups Hospice News; by Jesse Floyd; 8/14/24 As a sector, most standalone palliative care providers are still maturing from startups into long-term, sustainable businesses. ... This means gathering the necessary startup capital to take a new palliative care provider from idea to execution is often the first tangible goal for hopeful entrants into the space. When Jonathan Fluhart and Tiffany Hughes set about getting PalliCare, their Texarkana, Texas-based palliative care provider from theory to reality, they ran headlong into this obstacle. ... “Initially, what we thought we would do is build a palliative program that would nest between the home health and hospice,” Fluhart said. “We started to go into the community to talk with facilities and places that we felt would benefit from our services. Once they learned that we were tied to a home health provider, especially a hospice, it turned them off.” They decided the answer was two-fold: Sever ties with the hospice care provider they worked for; then start casting about for investors. ... 

Dr. El-Jawahri on the impact of palliative care on end-of-life care for AML and MDS OncLive; by Areej R. El-Jawahri, MD; 8/12/24 Areej El-Jawahri, MD, associate director, Cancer Outcomes Research and Education Program, director, Bone Marrow Transplant Survivorship Program, associate professor, medicine, Massachusetts General Hospital, discusses findings from a multi-site, randomized trial (NCT03310918) investigating a collaborative palliative oncology care model for patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) receiving nonintensive therapy at 2 tertiary care academic hospitals. Patients in the study who received the palliative care interventions had a median of 41 days from end-of-life care discussions to death, compared with 1.5 days in the standard care group (P < .001). Additionally, patients who received the palliative care interventions were more likely to articulate their end-of-life care preferences and have these preferences documented in electronic health records, El-Jawahri begins. This documentation correlated with fewer hospitalizations in the final 30 days of life, she notes. Furthermore, palliative care recipients experienced QOL improvements and a trend toward reduced anxiety symptoms vs the patients who received usual care, El-Jawahri says. These findings underscore the necessity of integrating palliative care as a standard of care for patients with AML and high-risk MDS, El-Jawahri emphasizes.

Palliative care is important in managing cardiovascular diseaseNJToday; 8/8/24Implementing patient-centered palliative care therapies, including prescribing, adjusting or discontinuing medications as needed, may help control symptoms and improve quality of life for people with heart disease, according to “Palliative Pharmacotherapy for Cardiovascular Disease,” a new scientific statement from the American Heart Association, published in the journal, Circulation: Cardiovascular Quality and Outcomes.