Literature Review
All posts tagged with “Palliative Care Provider News | Operations News | Financial.”
End-of-life care is a profound and essential aspect of medical practice
07/22/24 at 03:00 AMEnd-of-life care is a profound and essential aspect of medical practice Market.US Media, New York; by Samruddhi Yardi; 7/19/24 According to End-of-Life Care Statistics, End-of-life care, also known as palliative care, refers to the comprehensive medical, emotional, and psychological support provided to individuals who are nearing the end of their lives, often due to terminal illnesses or conditions. [This article includes data on the following:]
10 key Medicare Advantage updates in 2024
07/08/24 at 03:00 AM10 key Medicare Advantage updates in 2024 Becker's Payer Issues; by Rylee Wilson; 6/27/24 The first half of 2024 brought shifting trends for Medicare Advantage. Payers continued to warn of rising medical costs in the MA population, and some are predicting they will lose members next year. Insurers picked up a win in June when CMS said it would recalculate star ratings for 2024. Here are 10 key Medicare Advantage updates to know:
Medicare Program: End-Stage Renal Disease Prospective Payment System, Payment for Renal Dialysis Services Furnished to Individuals with Acute Kidney Injury, etc.
07/08/24 at 03:00 AMMedicare Program: End-Stage Renal Disease Prospective Payment System, Payment for Renal Dialysis Services Furnished to Individuals with Acute Kidney Injury, etc. Federal Register; Proposed Rule by the Centers for Medicare & Medicaid Services; 7/5/24
States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model
07/08/24 at 02:00 AMStates Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model CMS.gov; 7/2/24 On July 2, 2024 CMS announced that Connecticut, Maryland, and Vermont will be the first state participants in the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model. Hawaii will also participate, pending satisfaction of certain requirements. Applications to participate in Cohort 3 of the model are due August 12, 2024 at 3:00 p.m. EST (Cohort 3). Eligibility requirements and additional model details can be found in the NOFO. To stay up to date on model announcements, events, and resources, please sign up for the AHEAD Model listserv.
National health expenditure projections, 2023–32: Payer trends diverge as pandemic-related policies fade
07/06/24 at 03:25 AMNational health expenditure projections, 2023–32: Payer trends diverge as pandemic-related policies fade Health Affairs - Research Article - Costs & Spending; by Jacqueline A. Fiore, Andrew J. Madison, John A. Poisal, Gigi A. Cuckler, Sheila D. Smith, Andrea M. Sisko, Sean P. Keehan, Kathryn E. Rennie, and Alyssa C. Gross; 6/12/24 Health care spending growth is expected to outpace that of the gross domestic product (GDP) during the coming decade, resulting in a health share of GDP that reaches 19.7 percent by 2032 (up from 17.3 percent in 2022). National health expenditures are projected to have grown 7.5 percent in 2023, when the COVID-19 public health emergency ended. This reflects broad increases in the use of health care, which is associated with an estimated 93.1 percent of the population being insured that year. ... Amonth eh major payers, Medicare has the highest projected ten-year average spending growth rath, mainly because of enrollment into the program. [Click on the title's link to examine this article's content and tables.]
Lawmakers say CMS should ban Medicare Advantage’s use of AI to deny care
07/03/24 at 03:00 AMLawmakers say CMS should ban Medicare Advantage’s use of AI to deny care McKnights Long-Term Care News; by Josh Henreckson; 6/26/24 The Centers for Medicare & Medicaid Services should consider banning artificial intelligence from being used to deny Medicare Advantage coverage pending a “systematic review,” a group of 49 congressional leaders is urging. ... Skilled nursing providers have been sounding the alarm for years on Medicare Advantage coverage access, especially when informed by AI and other algorithms. Sector leaders have frequently noted that these methods can deny or prematurely end coverage for patients who need it to afford necessary long-term care. Providers and consumer advocates both spoke out in favor of the lawmakers’ letter this week. “LeadingAge’s nonprofit and mission driven members … have firsthand experience of Medicare Advantage (MA) plans’ inappropriate use of prior authorization to deny, shorten and limit MA enrollees’ access to medically necessary Medicare benefits,” wrote Katie Smith Sloan, president and CEO of LeadingAge. ... “Implementation by [the] Centers for Medicare and Medicaid Services (CMS), which we fully support, would ensure MA plans fulfill their obligation to provide enrollees equitable access to Medicare services.”
How the Supreme Court’s Chevron Decision could help stop home health cuts
07/02/24 at 03:00 AMHow the Supreme Court’s Chevron Decision could help stop home health cuts Home Health Care News; by Andrew Donlan; 6/28/24 On Friday, the U.S. Supreme Court upended the Chevron doctrine precedent. For home health industry purposes, that means a potentially weakened Centers for Medicare & Medicaid Services (CMS) moving forward. The news comes just two days after the home health proposed payment rule was released, which included significant cuts for the third straight year. Broadly, moving away from the Chevron precedent – usually known as the Chevron doctrine – will mean less regulatory power for government agencies. Government agencies often take their own interpretations of certain laws and statutes, and then act upon those interpretations. ... The National Association for Home Care & Hospice (NAHC) already filed a lawsuit against the U.S. Department of Health & Human Services (HHS) and CMS over rate cuts in 2023. “In our own analysis, we believe that providers of home health have been underpaid as it relates to budget neutrality,” NAHC President William A. Dombi said when the lawsuit was filed. “At minimum, we would expect to see the rate cuts from 2023, that were permanent readjustments to the base rate, and the one proposed for 2024, along with the temporary adjustments … to go away. The end product of that is that we would have a stable system to deliver home health services to Medicare beneficiaries.”
HHS to impose penalties on providers that block patients’ health information
06/28/24 at 03:00 AMHHS to impose penalties on providers that block patients’ health information McKnights Home Care; by Adam Healy; 6/24/24In a bid to promote easier access and exchange of patients’ health records, the Department of Health and Human Services published a final rule Monday outlining penalties for providers that block access to electronic health information. ... Fragmented and inaccessible patient data can prevent long-term and post-acute care providers from seeing the full picture of a patients’ health. Hospitals, for example, are not required to share updates about a patient’s health with the patient’s post-acute care provider. As a result, home health and home care agencies frequently cannot access patients’ electronic health records to help assess and treat patients. Three disincentives: ... First, hospitals that commit information blocking can be subject to a reduction of three quarters of an annual market basket update. Second, clinicians eligible for the Merit-based Incentive Payment System will receive a zero score in the “promoting interoperability performance” MIPS category, which can be equivalent to roughly a quarter of the clinician’s MIPS score in a given year. Lastly, providers that participate in information blocking can have their Medicare Shared Savings Program or Accountable Care Organization eligibility revoked for at least one year. ...Editor's Note: Almost any solution raises additional challenges. How does HIPAA interface with this? How might a cyberattack at a hospital (or other healthcare agency) affect the patients' other agencies, putting them at risk as well?
[Updated] CMS proposes over 4% cut to Home Health Medicare payments in 2025
06/28/24 at 02:00 AM[Updated] CMS proposes over 4% cut to Home Health Medicare payments in 2025 Home Health Care News; by Andrew Donlan; 6/26/24 The U.S. Centers for Medicare & Medicaid Services (CMS) published its FY 2025 home health proposed payment rule Wednesday. With it, the agency signaled that more significant cuts could be on the way for providers. To rebalance the Patient-Driven Groupings Model (PDGM) and make it budget neutral, at least according to its internal methodology, CMS is proposing a permanent prospective adjustment to the CY 2025 home health payment rate of -4.067%. For CY 2023 and CY 2024, CMS previously applied a 3.925% reduction and a 2.890% reduction, respectively.
‘Lot of work to be done’: What home health leaders expect from payment rulemaking in 2024
06/27/24 at 03:00 AM‘Lot of work to be done’: What home health leaders expect from payment rulemaking in 2024Home Health Care News; by Joyce Famakinwa; 6/24/24 In recent years, home health care has faced relentless cuts from the Centers for Medicare & Medicaid Services (CMS). It has plagued the industry, but providers and advocates alike are still hopeful a light at the end of the tunnel is ahead. ... Home Health Care News recently caught up with PQHH CEO Joanne Cunningham and David Totaro, the president and executive director of Hearts for Home Care. ... [Cunningham said,] "I anticipate that what we will see, given CMS’s posture and prior rulemaking cycles, is the continuation of the policy that will put in place permanent cuts to the Medicare home health program. We’re bracing ourselves for an additional sizable permanent cut. We don’t know exactly what CMS has planned for the temporary cuts, otherwise known as the clawback cuts. We will certainly see, at a minimum, CMS identify what their new projected value of the temporary cuts are. ...
Garnet Health shutters palliative care program
06/27/24 at 03:00 AMGarnet Health shutters palliative care program Hospice News; by Jim Parker; 6/25/24 New York state-based Garnet Health has announced a restructuring plan that spells the demise of its inpatient palliative care services. The plan includes layoffs of about 1% of the health system’s workforce, numbering 26 employees. This is estimated to save Garnett $4.6 million in salaries and benefits. “[Garnet] continues to be challenged with significant labor expenses, inflation on supplies and equipment, and low payor reimbursement rates,” the health system indicated in a statement. The restructuring is the result of financial headwinds, including decreased demand. Patient volumes are gradually increasing, but not yet to pre-pandemic levels, the company stated in an announcement.
48 health systems with strong finances
06/25/24 at 03:00 AM48 health systems with strong finances Becker's Hospital CFO Report; by Andrew Cass; 6/20/24 Here are 48 health systems with strong operational metrics and solid financial positions, according to reports from credit rating agencies Fitch Ratings and Moody's Investors Service released in 2024. Note: This is not an exhaustive list. Health systems were compiled from credit rating reports. [Click on the title's link for the list.] Editor's Note: This list is from larger "health systems," and does not reflect stand-alone hospice and palliative organizations.
The opportunity for palliative care in ACO Flex
06/25/24 at 03:00 AMThe opportunity for palliative care in ACO Flex Palliative Care NEws; by Audrie Martin; 6/24/24 On Jan. 1, 2025, the Center for Medicare and Medicaid Services (CMS) Innovation Center will begin implementing a payment model for primary care known as the Accountable Care Organizations (ACOs) Primary Care Flex Model under the Medicare Shared Savings Program (MSSP). The ACO Flex Model is a voluntary initiative to improve funding and other resources to support primary care delivery within the MSSP. The model encourages the formation of new, physician-led ACOs, particularly those serving underserved communities and addressing health disparities. This program is not just a test but also seeks to empower participating ACOs and their primary care providers to employ more innovative, team-based, person-centered and proactive approaches to care. [Click on the title's link for more information.]
Children’s hospices risk being ‘hugely reduced’ due to funding and cost issues
06/21/24 at 03:00 AMChildren’s hospices risk being ‘hugely reduced’ due to funding and cost issues Jersey Evening Post - UK News; by UK News; 6/19/24 Children’s hospice services are at risk of being “hugely reduced” amid a lack of long-term sustainable funding and rising costs, a charity has warned. ... Some 66.7% of children’s hospices said this was due to a hike in energy bills, while 86.1% said it was due to higher costs associated with recruiting and retaining staff. According to the report, some 54% of children’s hospices in the UK ended the 2023/24 financial year in a net deficit. Together for Short Lives extrapolated the figure across all 39 hospice organisations to estimate a total shortfall of £8.5 million.
HHS to end Medicare pay program after Change Healthcare breach
06/20/24 at 03:00 AMHHS to end Medicare pay program after Change Healthcare breach Bloomberg Law; by Tony Pugh; 6/17/24The Biden administration announced plans Monday to terminate a program that provided more than $3.2 billion in accelerated and advance Medicare payments to hospitals, physicians, and others suffering cash flow disruptions following the Change Healthcare cyberattack in February. Medicare payments under the Accelerated and Advance Payment (AAP) Program for the Change Healthcare/Optum Payment Disruption (CHOPD) will end on July 12, the Centers for Medicare & Medicaid Services announced.
Global digital health outlook and growth report 2024: Care at home and alternative sites will see a growing preference, focus will be on adoption across clinical and operational use cases
06/20/24 at 03:00 AMGlobal digital health outlook and growth report 2024: Care at home and alternative sites will see a growing preference, focus will be on adoption across clinical and operational use cases Classic 96.7 FM; by Business Wire; 6/17/24The digital health industry has maintained a consistent growth trajectory. Investing in technologies that help organizations achieve the quintuple aim of healthcare is a constant priority. However, high inflation and tight monetary policy will impact the investment landscape as it shifts from top-line growth to profitability. ... Change management initiatives will require stakeholder education to understand the pros and cons of newer technology initiatives and work alongside these to improve clinical and operational processes. Top 2024 Digital Health Predictions:
RN pay for all 50 states adjusted by cost of living | 2024
06/18/24 at 03:00 AMRN pay for all 50 states adjusted by cost of living | 2024 Becker's Hospital Review; by Mackenzie Bean; 6/13/24 California has the highest hourly mean wage for registered nurses, even after adjusted for cost of living, according to data from the Bureau of Labor Statistics. [Following] are the mean hourly wages for nurses in all 50 states and Washington, D.C., adjusted for cost of living. Becker's calculated these figures using May 2023 salary data from BLS and 2024 cost of living index data from the World Population Review. (Click on this title's link for each state's (1) RN hourly mean wage, (2) Cost of living index, and (3) RN hourly mean wage, adjusted by cost of living.
AAHPM CMO Joe Rotella: Hospice does not exist to save money
06/18/24 at 02:00 AMAAHPM CMO Joe Rotella: Hospice does not exist to save money Hospice News; by Jim Parker; 6/17/24Dr. Joe Rotella, chief medical officer of the American Academy of Hospice and Palliative Medicine (AAHPM), calls on hospices to maintain their core principles amid a churning sea of regulatory and economic changes. Rotella began his medical career as a primary care physician in a small, rural town in central New Hampshire, where he stayed for 12 years [followed by serving Hospice & Palliative Care of Louisville, KY/Hosparus as Chief Medical director for 15 years]. ... Now, Rotella will soon retire from AAHPM. Hospice News sat down with Rotella to discuss the ways hospice and palliative care have changed during his tenure in the space, as well as the forces shaping the field’s future. ...
Advocates rally in DC for the future of hospice: NHPCO and HAN amplify provider voices on Capitol Hill
06/17/24 at 03:00 AMAdvocates rally in DC for the future of hospice: NHPCO and HAN amplify provider voices on Capitol Hill NHPCO; Press Release; 6/13/24 More than 100 hospice and palliative care advocates from across the country met with over 150 congressional offices this week to discuss key legislative and regulatory priorities for ensuring and expanding access to hospice and palliative care. The meetings were part of Hospice Action Week, hosted in Washington, DC by the National Hospice and Palliative Care Organization (NHPCO) and its advocacy affiliate, the Hospice Action Network (HAN). “The cornerstone of effective advocacy is storytelling. It’s about sharing why hospice holds personal significance and why serious illness and end-of-life care policy should resonate with our lawmakers,” said Logan Hoover, NHPCO’s VP of Policy & Government Relations. “From Hawaii to Rhode Island, advocates from 35 diverse states came to DC this year. The relationships they’re building with Members of Congress hold the potential to shape the future of the healthcare landscape.”
4 CFOs' keys to improved operating performance
06/17/24 at 03:00 AM4 CFOs' keys to improved operating performance Becker's Hospital CFO Report; by Andrew Cass; 6/13/24Altru, Memorial Health, Penn State Health and Sharp HealthCare are among the systems that reported improved year over year operating performance in their most recent financial reports. Becker's asked the CFOs of the four health systems to share one key to their boosted operating performance: ...
Hawaiʻi is the first state to provide palliative care coverage
06/05/24 at 03:00 AMHawaiʻi is the first state to provide palliative care coverage EIN Presswire; by Governor JOsh Green, MD; 4/4/24 Governor Josh Green, M.D., and the Department of Human Services (DHS) Med-QUEST Division are pleased to announce that the Centers for Medicare and Medicaid Services (CMS) approved a new State Plan Amendment (SPA) to cover community palliative care services through Medicaid, making Hawaiʻi the first state in the nation to do so. ... “After several years of hard work and collaboration with many community members and experts in the field, I am proud to announce that Med-QUEST is the first Medicaid program in the country to get this benefit approved,” said Governor Green. “This will greatly improve the quality of life and health outcomes for thousands of people who face serious medical conditions in our state. Hawaiʻi continues to lead the nation in innovations in health and health care.”
LeadingAge: CMS on right track with high-acuity hospice RFI
06/05/24 at 03:00 AMLeadingAge: CMS on right track with high-acuity hospice RFIHospice News; by Jim Parker; 5/31/24 The senior care advocacy group LeadingAge has praised the U.S. Centers for Medicare & Medicaid Services (CMS) inquiries into high-acuity palliative care, but expressed concern over reimbursement and staffing issues. The agency’s 2025 proposed hospice rule featured a series of requests for information (RFI) on issues like health equity, social determinants of health and future quality measures. The RFIs contain further questions about the utilization of higher-cost palliative treatments under the Medicare Hospice Benefit. The agency posed similar queries in its proposed rule for 2024. The new proposal seeks greater clarity on the financial risks and costs that providers say represent barriers to providing those services, such as palliative chemotherapy, radiation blood transfusions or dialysis, among others.
The real cost of cancer: 49% of patients carry $5K+ in medical debt
05/30/24 at 02:00 AMThe real cost of cancer: 49% of patients carry $5K+ in medical debt Becker's Hospital Review; by Ashleigh Hollowell; 5/28/24 ... Now, 47% of cancer patients accumulate debt as a result of their medical needs, The Wall Street Journal reported May 28. ... Some Americans are facing $38,000 or even more in medical debt, the Journal found. Additionally, more cancer patients are filing for bankruptcy, which one study linked to an 80% increased risk of dying. ... A 2024 survey of 1,284 cancer patients and survivors led by the American Cancer Society Cancer Action Network also found that: ...
Healthcare sees highest Chapter 11 bankruptcy filings in 15 years: report
05/27/24 at 02:30 AMHealthcare sees highest Chapter 11 bankruptcy filings in 15 years: reportMcKnights Senior Living; by Kathleen Steele Gaivin; 5/20/24Chapter 11 bankruptcies in healthcare, including senior living reached a multiyear high in the first quarter of 2024. That’s according to the newest Polsinelli-TrBK Distress Indices Report, published Wednesday. “We continue to see intense stress in senior living,” Jeremy R. Johnson, a bankruptcy and restructuring attorney at Polsinelli and co-author of the report, said in a press release issued in conjunction with the report. ... The Southeast continues to outpace the rest of the country as the busiest region for bankruptcy filings, according to the report. The Southeast region reported 33.4% of the filings in the first quarter, followed by Northeast and Delaware at 30.8% and 16.1%, respectively. Since the benchmark period of 2020, the Northeast has shown the biggest increase in filings.
Transformative peer connections: Early experiences from the ASCO Palliative Care Community of Practice
05/27/24 at 02:00 AMTransformative peer connections: Early experiences from the ASCO Palliative Care Community of Practice American Society of Clinical Oncology; by Mazie Tsang, Cristiane Bergerot, Natasha Dhawan, Rushil Patel, Darcy Burbage, Tingting Zhang, Jafar Al-Mondhiry, Joseph McCollom, Ramy Sedhom; 5/22/24 online ahead of print in June 2024 ... there are barriers to implementing palliative oncology at many institutions for myriad reasons. ... In this article, we discuss an innovative strategy that ASCO implemented called the Communities of Practice (CoP). We share our experiences as the Palliative Care CoP and how our group seeks to develop processes and structures to collectively promote systemic change and enhance palliative care delivery for people with cancer. Our Palliative Care CoP engages with senior leaders, administrators, and those in power to achieve a shared vision of delivering holistic health care for people with serious illness. ... [We address] eight main domains: