Literature Review

How to transform a health system’s organizational culture and hardwire it for the futureNEJM Catalyst; by Brian Carlson, Nancy M. Lorenzi, Paul Sternberg, Jr., Cassandra Hennessy, Dandan Liu; 4/26Organizational culture is a critical driver of workforce and patient experience, yet health care institutions often struggle to sustain their desired culture over time. In 2017, Vanderbilt Health identified inconsistencies in expected workforce behaviors through patient feedback, prompting the creation of a strategic cultural renewal initiative. The resulting program, Defining Personalized Care, had a 4-year road map of seven e-learning modules designed to reinforce core values and improve interpersonal behaviors across the workforce. This single-center pre–post study revealed statistically significant improvements in patient experience scores, particularly in the communication and courtesy domains. The initiative demonstrated that engaging, relevant content combined with visible support from leadership can drive voluntary participation and generate measurable outcomes. This case study offers a replicable framework for health care organizations seeking to hardwire their cultural expectations and align workforce behaviors with patient-centered care goals.

Hawai'i Attorney General rejects characterization of Medicaid fraud enforcement and defends state's enforcement record Hawai'i Free Press, Honolulu, HI; by News Release from Department of the Attorney General; 5/14/26The Department of the Attorney General today rejected recent claims that Hawaiʻi “isn’t taking Medicaid fraud seriously,” calling the claims by Vice President J.D. Vance false and unsupported by the record. Since 2021, the Medicaid Fraud Control Unit (MFCU) has secured or helped secure judgments, settlements and recoveries in 25 cases, totaling $14,094,547.91. Last year, the MFCU secured a $30,000 settlement against a Medicaid provider for fraudulent billing. Earlier this year, the MFCU secured another Medicaid fraud settlement in the amount of $208,317.69. The MFCU also filed criminal charges earlier this year against two individuals, one of whom has already pleaded no contest as charged. [Hawai'i Medicaid Fact Sheet] Editor's Note: This article references "Hawaii's Medicaid coverage for palliative care expected to save the state money," which describes, "Hawaii is the first state to include palliative care in its Medicaid plan."

Palliative care and age-friendly care - CAPC Position Statement CAPC | Center to Advance Palliative Care; Position Statement; 5/11/26 The U.S. health care system is evolving to better meet the needs of a rapidly growing aging population by advancing age-friendly care. CAPC’s position statement outlines how palliative care can accelerate IHI recognition and support success with CMS measures. It also offers practical recommendations for leaders and policymakers to integrate palliative care into age-friendly care.

Palliative care loss hits Durango patients The Durango Herald, Durango, CO | Letters to the Editor; by Stacey Ebel; 4/24/26 My emotions are running high after learning about CommonSpirit Mercy Hospital discontinuing their palliative care program. ... My mother moved here in 2020 with numerous health issues, and I enrolled her in palliative care as I knew that at some point she would need to transition to hospice. Her palliative care nurse practitioner, Jen, visited my mother monthly in her apartment ...  Potential and past patients will now have to go to the ER or their personal PCPs for treatment. Recently, the last palliative care nurse had to discharge 200 patients. 

U.S. AI boom could cause health care costs to soar without changes to payment policy Penn LDI - Leonard Davis Institute of Health Economics; by Julia Hinckley, JD; 4/8/26 ... AI is already affecting health care delivery, and the choices policymakers make about payment will define its future trajectory, says LDI Senior Fellow Amol Navathe. AI is already more scalable and varied in its actions than human services. But without policies that create financial incentives to improve care, we risk driving up costs without improved outcomes or stifling innovation, writes Navathe in a recent perspective piece in Health Affairs.

Mass AI job replacement? Not in healthcare, CIOs say Becker's Health IT; by Giles Bruce; 3/18/26 While some doomsayers predict that AI will replace human workers en masse, health system CIOs told Becker’s that healthcare, so reliant on the human touch, is safe. But that doesn’t mean duties won’t change dramatically. In late February, an investment analyst scenario outlining economic cataclysm caused by AI momentarily jolted the stock market. The authors, from Citrini Research, imagined white-collar job openings “collapsing” in late 2026, with blue-collar hiring staying “relatively stable.” While healthcare may be best described as “gray-collar,” the sector is still the nation’s largest employer, driving much of the country’s job growth over the past few decades. Could AI change that equation? ...

HCA’s CEO-to-worker pay ratio widens in 2025  Becker's Hospital Review; by Andrew Cass; 3/16/26 Nashville, Tenn.-based HCA Healthcare CEO Sam Hazen was paid 420 times more than the health system’s median employee in 2025, according to a March 13 proxy statement filed with the Securities and Exchange Commission. Mr. Hazen’s total compensation was $26,456,606 in 2025. The total compensation of HCA’s median compensated employee was $62,955. The ratio of these amounts was 420:1. 

[United Kingdom] Specialist palliative care has the potential to reduce costs by up to £8,000 per person and improve quality of life, according to new research published in Palliative Medicine Innovation News Network; by Megan Traviss; 3/10/26 Led by researchers at King’s College London, the research considered two modes of palliative care for those living at home and for those in acute hospital settings. As well as significantly reducing the overall cost of care per person, specialist palliative care delivered at home and in the hospital was associated with improved quality of life for patients in their final months. Peter May, Senior Lecturer in Health Economics at King’s College London and lead author of the study, stated: “This is the first study to estimate the economic impact for England.

Value-based models, Medicaid driving palliative care changes in 2026 Hospice News; by Holly Vossel; 2/23/26 The palliative care landscape has seen tremendous growth in recent years, according to Brynn Bowman, CEO of the Center to Advance Palliative Care (CAPC). Evolutions in value-based and state-level payment models have played an important role in moving the needle toward greater standardization, Bowman said during Hospice News’ Palliative Care Outlook webinar. ...

Defining palliative care quality in a tight reimbursement environment Hospice News; by Holly Vossel; 1/27/26 Palliative care delivery is undergoing an evolutionary period of change. These services are offered in several different ways across the country, which brings both benefits and challenges when it comes to defining quality in the space. Today’s palliative care providers are shaping the outlook of the field, but through diversified approaches, according to Brynn Bowman, CEO of Center to Advance Palliative Care (CAPC). The field is reaching a pivotal stage when it comes to supply and demand or resources, an issue that greater standardization could help to address, she indicated. 

The malady of delayed palliative care McKnights Long-Term Care News; by Avi Steinberg; 1/21/26 This article asserts that while nursing homes face increasing pressure to deliver value-based, goal-concordant care, palliative care—one of the most effective tools to achieve these aims—remains underused and introduced far too late. The problem is not a lack of evidence, but systemic barriers: delayed identification, misaligned payment models, and workforce shortages. Earlier integration of palliative care can reduce unnecessary hospitalizations, lower costs, and improve resident and family experience. Treating palliative care as a standard of care rather than a last resort is an operational necessity for long-term care.