Literature Review

US trends from 1999 to 2020: Mortality and location of deaths in ischemic stroke Neurology Advisor; by Meghna Rao; 6/2/25 Patterns of ischemic stroke mortality have varied over the last 2 decades in the United States, according to study findings published in PLOS One. Stroke is one of the leading causes of mortality in the US. Researchers studied the trends in location of ischemic stroke deaths to improve end-of-life care and address health care inequities.The Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database was used to examine trends in ischemic stroke mortality between 1999 and 2020. 

CMS’ TEAM Payment Model: What hospices need to know Hospice News; by Jim Parker; 5/30/25 A forthcoming alternative payment model for hospitals focuses on discharge planning and ensuring effective post-acute care, including hospice and palliative care when appropriate. The U.S. Centers for Medicare & Medicaid Services (CMS) late last year unveiled its new Transforming Episode Accountability Model (TEAM). Participation in the model will be mandatory for select hospitals. The program is set to launch on Jan. 1, 2026 and run through Dec. 31, 2030. CMS designed the program based on lessons learned from previous episode-based payment models, as well as input from stakeholders in response to a Request for Information published in 2023.  

Timing and outcomes of palliative care integration into care of adolescents and young adults with advanced cancerOncology Practice; Jeremiah Bonnet, BA; Colin Cernik, MS; Hajime Uno, PhD; Lanfang Xu, MS; Cecile A. Laurent, MS; Lauren Fisher, MS; Nancy Cannizzaro, BA; Julie Munneke, BA; Robert M. Cooper, MD; Joshua R. Lakin, MD; Corey M. Schwartz, MD; Mallory Casperson, BA; Andrea Altschuler, PhD; Lawrence H. Kushi, ScD; Chun R. Chao, PhD; Lori Wiener, PhD; Jennifer W. Mack, MD, MPH; 5/25Adolescent and young adult (AYA) patients with cancer frequently receive intensive measures at the end of life; many also express care goals that align with a palliative approach. [In this study] nearly three quarters (73%) [of  AYA patients] were referred to palliative care before death. Thirty-six percent of palliative care referrals took place before the last 90 days of life; 30% were in the last month of life. Palliative care referrals and their timing were associated with care received at the end of life, with earlier referrals associated with fewer intensive measures near death, including chemotherapy in the last 14 days of life ... as well as intensive care unit admissions, emergency room visits, and hospitalizations in the last month of life ... Patients who were referred to palliative care were more likely to have symptoms assessed in the last 90 days of life, including pain, dyspnea, nausea, diarrhea, constipation, depression, and anxiety ... 

Hospitalists should champion hospice as ‘life with dignity’ Medscape; by Julie Peck; 5/29/25 If anyone can put a positive spin on the end of life, it’s Charles Vialotti, MD, director of Hospice Care at Holy Name Medical Center’s Villa Marie Claire in Bergen County, New Jersey. Violotti, who at the age of 80 lives at the 20-bed Villa Marie Claire to serve its residents full-time, says the hospice industry needs hospitalists’ help with sort of a rebrand, one that will almost certainly have a positive effect on patient and family satisfaction. “Providers used to stress offering people death with dignity. And if you think about that, who is ever going to choose anything that offers death? Death in any form is still death,” Vialotti said. “So, we really like to focus on offering people life with dignity, giving people back choice, giving them the option to structure their final days, weeks, or months the way they would most like to see it happen."

WHO unveils new guideline to improve global access to controlled medicines World Health Organization; by Departmental update; 5/26/25 The World Health Organization (WHO) has released a rapid communication outlining its comprehensive new guideline on balanced national policies for controlled medicines. The guideline’s recommendations were officially presented during a high-level side event at the Seventy-eighth World Health Assembly on Friday 23 May 2025. It is designed to support countries in ensuring safe, equitable and affordable access to essential controlled medicines which are critical for treating acute and chronic pain, mental health conditions, substance use disorders and other serious health issues.

National Alliance for Care at Home publishes CONNECT to Care Report National Alliance for Care at Home, Alexandria, VA and Washington, DC; Press Release; 5/27/25 The National Alliance for Care at Home (the Alliance) published the results of new research conducted by Transcend Strategy Group exploring perceptions of hospice care among underserved communities. This research compiles findings from a series of surveys of 2,000 people and explores perceptions of hospice care among Black, Hispanic, Asian American, LGBTQ+, and rural communities. Using the CONNECT acronym – Communication, Outcomes, Network, Nurture, Engagement, Collaboration, and Transparency – the report aims to help providers support equitable, inclusive, and comprehensive access to care and is part of the Alliance’s ongoing commitment to increasing access to hospice and home care through knowledge sharing, data collection, and collaborative discussion.  Along with key research findings, CONNECT to Care offers recommendations for hospice providers to help increase understanding of hospice care and help overcome barriers to access.  

Johnson champions Eddie's Law to bring dignity to end-of-life-care in Illinois Public, Springfield, IL; News Release; 5/22/25 After an incarcerated man named Eddie Thomas died alone in a prison infirmary without receiving any end-of-life care, State Senator Adriane Johnson is championing legislation to bring dignity, compassion, and transparency to hospice and palliative care services in Illinois correctional facilities. "This bill is about basic human dignity," said Johnson (D-Buffalo Grove). "No one should die in pain, in isolation or without the comfort of care - no matter who they are or where they live. House Bill 2397 brings transparency to a system that too often leaves people to suffer silently." ... House Bill 2397 would require the Illinois Department of Corrections to prepare and publish an annual report detailing its hospice and palliative care programs. The bill aims to provide lawmakers with data that can guide future policy decisions on compassionate and medically appropriate end-of-life care for people incarcerated in Illinois. 

A practice model for palliative radiotherapyCureus; Alina Zheng, Alec Zheng, Alan Zheng, Xiaodong Wu, Beatriz Amendola; 5/25Despite well-recognized challenges in implementing palliative radiation therapy (PRT), progress remains slow, and conventional approaches have yielded limited success. A specialized certification track within radiation oncology residency programs is proposed, enabling palliative care physicians to obtain limited PRT licenses under the supervision of fully licensed radiation oncologists. Dedicated PRT facilities-affiliated with comprehensive radiation therapy centers (CRTCs) and integrated into hospice settings-will enhance accessibility by reducing logistical and financial burdens. These facilities will utilize cost-effective infrastructure, including refurbished linear accelerators, modular construction, and remote physics and dosimetry support, ensuring operational costs remain significantly lower than those of conventional radiotherapy centers. Systematic studies with a PRT-oriented mindset should establish PRT-specific treatment recommendations and recommendations, moving away from conventional radiation therapy protocols. While requiring initial investment and regulatory adjustments, it has the potential to improve end-of-life care for terminally ill cancer patients, ensuring greater dignity and comfort while establishing a robust foundation for future reimbursement models.

‘Wake-up call’: Aggressive cancer care common at end of life, supportive care lackingHealio; by Josh Friedman; 5/22/25Nearly half of people with advanced cancer receive aggressive care at the end of life, a rate little changed from a decade ago. At the same time, use of palliative or supportive care remains rare, despite increasing evidence that they are a key component of high-quality, patient-centered care. ... Meanwhile, two other studies showed oncologists’ individual practice patterns and institutional resources can play a significant role in determining which patients receive systemic therapy or early palliative care at the end of life.

Q&A: Addressing palliative care in dialysis settings Physician's Weekly; interview with Jane O. Schell, MD; 5/20/25 Jane O. Schell, MD, discusses factors that impact use of palliative care in dialysis settings for patients in the United States, as well as potential solutions. 

Podcast: Innovations and insights in the palliative care space Holland & Knight; podcast by Daniel Patten and Spencer Freeman; 5/20/25 In this episode of "Counsel That Cares," Daniel Patten, a partner in Holland & Knight's Healthcare Regulatory & Enforcement Practice, and Spencer Freeman, chief strategy officer at Gentiva, discuss the challenges and opportunities that come with delivering integrated palliative care services, highlighting the lack of a defined Medicare benefit for palliative care compared to more established models such as hospice. Mr. Freeman shares insights on building care models that serve high-risk patient populations through coordinated interdisciplinary teams and data-driven approaches, emphasizing the importance of collaboration with risk-based primary care providers. Mr. Patten adds a legal perspective on the evolving landscape of value-based care contracts, artificial intelligence (AI) integration and regulatory compliance. Together, they explore how innovative programs can improve patient outcomes, reduce acute care utilization and facilitate payer relationships, offering a comprehensive view of the future of palliative care within value-based healthcare delivery.

New standards could transform palliative care for dementia patients McKnights Long-Term Care News; by Donna Shryer; 5/15/25 An Invited Commentary published Wednesday [5/14/ in JAMA Network Open highlights vital new consensus on when to refer dementia patients to specialist palliative care. The commentary, authored by Laura J. Morrison, MD, from Yale University School of Medicine, analyzes the Delphi survey study, which established the first international agreement on palliative care referral criteria for dementia patients.The Delphi survey study, led by Yuchieh K. Chang, DO, and colleagues, brought together 63 experts from five continents who identified 15 major criteria for specialist palliative care referral, grouped into five categories: dementia type, symptom distress, psychosocial factors, comorbidities and hospital use. Each major criterion was considered sufficient on its own to warrant referral, even for patients expected to live more than two years. Additionally, the study outlined 42 minor criteria, which could be used in combination to justify a referral decision.

A narrative review—Characterizing palliative care curriculum aimed at high school adolescents and young adultsIllness, Crisis and Loss; Austin B. Elder; 4/25The aim of this narrative review is to explore the characteristics of palliative care curriculum developed for high school adolescent and young adults (AYAs). Characteristics including a variety of designs, methods, and strategies were all identified to have positive participation, feedback, and experiences from high school AYA being provided palliative care curriculum. Conclusions: The literature indicates that the use of subject matter experts within palliative care curriculum for high school students is a core characteristic in meeting the World Health Organizations recommendation to embed palliative care curriculum into public awareness strategies.