Literature Review

Postpandemic, telehealth preferred in outpatient palliative care setting Rheumatology Advisor; by Lisa Kuhns, PhD; 5/1/24 Even after the SARS-CoV-2 vaccine against COVID-19 became available, patients preferred outpatient palliative care visits via video rather than in person, according to study results published in the Journal of Pain and Symptom Management. ... The researchers ... added, “Although telehealth may be preferable for reasons beyond social distancing, this survey found that COVID-19 transmission was still a [postpandemic] concern for some patients, where telehealth can be advantageous. These concerns reflect [an] ongoing sentiment [that] patients with advanced cancer, who are often immune-compromised, have with regards to the pandemic even after widespread vaccine availability and end of COVID-19 restrictions. 

HHS issues new rule to strengthen nondiscrimination protections and advance Civil Rights in health careHHS Press Office; 4/26/24Today, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) and the Centers for Medicare & Medicaid Services (CMS) issued a final rule under Section 1557 of the Affordable Care Act (ACA) advancing protections against discrimination in health care. By taking bold action to strengthen protections against discrimination on the basis of race, color, national origin, sex, age, and disability, this rule reduces language access barriers, expands physical and digital accessibility, tackles bias in health technology, and much more.

'Why we need to talk about dying': Thames Hospice and the reality of palliative careMaidenhead Advertiser; by Sam Leech; 4/27/24What is your understanding of what a hospice does?Many would suggest it is a place where people go to die – but there is much, much more to the journey of patients and loved ones at Thames Hospice [United Kingdom]. ... Catherine McLaughlin, the hospice’s chief executive, said: “This is a place where – yes, death is a big part – but it’s about how do you make memories? How do you give hope at a time when there might not be much of that? Those final days in somebody’s life is a very important time and the lasting memories are important to those who are left behind.”Editor's Note: Too often--in order to make hospice palatable to another's "sign-on-the-dotted-line-so-we-can-admit-you"--marketing professionals overtly deny that hospice is about "dying," "death," or "grief." Take note from this CEO who sensitively weaves in death, dying and bereavement for not only hospice, but also for "palliative care" with gentle, authentic conversation and questions to the public.

Living well to the end: Singapore ramps up palliative and hospice care capacityThe Straits Times; by Joy Teo; 4/26/24 Singapore is increasing its palliative care and hospice capacity to allow more people with life-threatening illnesses to live well till the very end, and die with dignity and comfort. By 2025, there will be 300 inpatient palliative care beds, 140 day hospice places and capacity for palliative home care for 3,600 patients. In Singapore, the term palliative care is often used interchangeably with hospice care, though there are subtle differences.

Leadership's perceptions of palliative care during the COVID-19 pandemic: A qualitative study Journal of Pain and Symptom Management, by Tamara Vesel, Audrey Covaleski, Veronica Burkarth, Emma Ernst, Linda Vesel; 4/19/24Background: This study aimed to explore the perceptions, understanding, and utilization of palliative care before compared to during the COVID-19 pandemic among health system leadership. Results: ... Emerging themes included the role of palliative care before compared to during the COVID-19 pandemic, facilitators and barriers to palliative care delivery, and recommendations for future practice. Participants reported that the COVID-19 pandemic increased palliative care utilization, reinforced positive perceptions of the specialty, and emphasized its role in maximizing healthcare efficiency. Many participants found palliative care financing to be a barrier to delivery; ... 

Psychosocial distress screening among interprofessional palliative care teams: A narrative review Journal of Social Work in End-of-Life & Palliative Care, by Chelsea K Brown and Cara L Wallace; 4/23/24With increased need for palliative care and limited staffing resources, non-social workers are increasingly responsible for screening for urgent psychosocial distress. The National Consensus Project guidelines call for all palliative care team members to be competent in screening across domains. ... Although an abundance of validated screening tools exists for outpatient oncology-specific settings, there is minimal guidance on psychosocial screening tools intended for specialty palliative care. The most oft-cited tools have been met with concern for validity across diverse palliative care populations and settings. ...  

What the ‘fundamentally contradicting’ Medicaid Access Rule includes Home Health Care News, by Andrew Donlan; 4/22/24 The White House teased the finalized Medicaid Access Rule early Monday, and the Centers for Medicare & Medicaid Services (CMS) later revealed more intricate details attached to the rule. [The] timeline of the rule is now clear. Specifically: ... [Click on the title's link for more]

Community partnership with Hinds Hospice brings supportYourCentralValley.com - MedWatch Today; by Juanita Adame; 4/22/24Facing difficult end-of-life decisions for loved ones is difficult. Community Regional Medical Centers has partnered with Hinds Hospice to bring in an extra layer of support to patients and their families inside the hospital. The services are for patients who cannot be cared for at the home during their end-of-life journey. “We started looking at institutions that could partner with us around delivering inpatient hospice care, not only to reduce our length of stay but to be able to provide a higher level of care for patients in hospice,” said Tina Gulbronsen, VP of Capacity Management at Community Medical Centers. “So this change means that there are some patients that can’t be discharged safely  because they are in some sort of crisis.”

Md. health dept. processed 1.5 million Medicaid enrollees in 12 months; one month left in ‘unwinding’Maryland Matters, by Danielle J. Brown; 4/19/24... Prior to the pandemic people with Medicaid insurance had to reapply annually. Medicaid terminations were paused over the COVID pandemic in order to ensure people were covered during a global health crisis. But starting in 2023, Medicaid re-enrollments were no longer automatic, and people had to reenroll in the program to continue coverage in a period often referred to as the ‘Medicaid unwind.’ ... At the start of the unwinding period, the data show that there were about 1,787,000 people enrolled in Medicaid in March 2023. A year later, there are 1,690,000 people covered by the program. ... But most of the terminations are due to what are called “procedural terminations,” which means that someone either did not start or did not complete their Medicaid reapplication. ... People with procedural terminations have short window after losing coverage when they can reapply to Medicaid and get covered again if they are still eligible.  

Integrating AI in Palliative Care: A comparative perspectiveElBlog.PL - Decoding AI: Unveiling the Future of Machine Intelligence, by Roman Rember; 4/19/2Jan Gärtner (51), the head of a Palliative Center in Basel, Switzerland, recently shed light on the fundamental differences in the use of artificial intelligence (AI) in palliative care across the United States and Switzerland. ... The Swiss model emphasizes the commencement of palliative care much earlier in the patient’s journey. ...

Black patients with ovarian cancer had lower-quality end-of-life care, study says American Journal of Managed Care (AJMC), by Brooke McCormick; 4/21/24 Non-Hispanic Black (NHB) patients with ovarian cancer (OC) received lower-quality end-of-life (EOL) care than non-Hispanic White (NHW) patients, according to a study published in Cancer Research Communications. ... Although trends and disparities in EOL care among patients with OC are well documented, the researchers noted that the role of health care access (HCA) in quality EOL care has not been well characterized; HCA is comprised of 5 distinct, interrelated care access dimensions, namely affordability, availability, accessibility, accommodation, and acceptability. 

States with the best health outcomes still have deep racial disparities STAT, by Usha Lee McFarling; 4/18/24 A new analysis of health inequities in the United States shows that every state has deep racial and ethnic disparities in the performance of their health care systems. The report released Thursday by the Commonwealth Fund analyzed 25 indicators that track health outcomes, health care access, and quality of care provided for five racial and ethnic groups. It found dramatic disparities for Black, Hispanic, and Indigenous Americans, even in Rhode Island, Massachusetts, Connecticut, Hawaii, New Hampshire, and New York — the states considered to have the best overall health care performance. In all states, White and Asian residents had the best health outcomes. 

What home health providers can learn from CMS’ other proposed rules for 2025Home Health Care News, by Joyce Famakinwa; 4/19/24... CMS released the 2025 proposed payment rules for hospice and skilled nursing facilities (SNFs) in March. On the hospice side, the proposed rule included a 2.6% increase in the per diem base rate. Aside from the pay raise for hospices, the proposal also included a market basket index update, and notable changes to some of the geographic areas subject to particular indices. “There are rural areas that became urban and urban areas that became rural in the new CBSs — core based statistical areas,” William A. Dombi, president of the National Association for Home Care & Hospice (NAHC), told Home Health Care News.