Literature Review
All posts tagged with “Palliative Care Provider News | Operations News | Financial.”
Should the DOJ break up UnitedHealth Group?
03/19/24 at 02:00 AMShould the DOJ break up UnitedHealth Group? MedCity News, by Marissa Plescia; 3/17/24 The U.S. Department of Justice has reportedly recently launched an antitrust investigation of UnitedHealth Group, which begs the question of whether the healthcare giant should be broken up. Experts have varying opinions.
Use of machine learning to optimize referral for early palliative care: Are prognostic predictions enough?
03/19/24 at 02:00 AMUse of machine learning to optimize referral for early palliative care: Are prognostic predictions enough Journal of Clinical Oncology - Editorials; by Gary E. Weissman, MD, MSHP; Joseph A. Greer, PhD; and Jennifer S. Temel, MD; 3/15/24 The Takeaway In the article that accompanies this editorial, [Weissman] et al used a machine learning (ML) algorithm to identify patients with advanced cancer who were receiving non–curative-intent treatment and at risk of death within 1 year to allocate early palliative care services at least 6 months before death as a means to increase use of early palliative care in the context of limited resources. While ML prognostic models are one promising strategy for triaging palliative care services, initiation of palliative care based exclusively on estimated survival and in the months before death likely excludes patients who would benefit from early palliative care initiated at the time of diagnosis, regardless of their estimated survival.
Can we make more accurate prognoses during last days of life?
03/14/24 at 03:00 AMCan we make more accurate prognoses during last days of life?Journal of Palliative Medicine; by Sylvie Bouchard, Andreea Paula Iancu, Elena Neamt, François Collette, Sylvie Dufresne, Patricia Maureen Guercin, Suganthiny Jeyaganth, Desanka Kovacina, Taliá Malagón, Laurie Musgrave, Marilisa Romano, Jenny Wong, Sybil Skinner-Robertson; 3/8/24Background: ... Established methods (Palliative Performance Scale [PPS], Palliative Prognostic Index [PPI]) have been validated for intermediate- to long-term prognoses, but last-weeks-of-life prognosis has not been well studied. Patients admitted to a palliative care facility often have a life expectancy of less than three weeks. Reliable last-weeks-of-life prognostic tools are needed. Conclusions: ... Using SPS [Short-Term Prognosis Signs] along with PPS and PPI during the last weeks of life could enable a more precise short-term survival prediction across various end-of-life diagnoses. The translation of this research into clinical practice could lead to a better adapted treatment, the identification of a most appropriate care setting for patients, and improved communication of prognosis with patients and families.
CMS Statement on continued action to respond to the cyberattack on change healthcare
03/14/24 at 02:00 AMCMS Statement on continued action to respond to the cyberattack on change healthcareCMS.gov Press Release; 3/9/24 The Centers for Medicare & Medicaid Services (CMS) is continuing to monitor and assess the impact that the cyberattack on UnitedHealth Group’s subsidiary Change Healthcare has had on all provider and supplier types. Today, CMS is announcing that, in addition to considering applications for accelerated payments for Medicare Part A providers, we will also be considering applications for advance payments for Part B suppliers.
Palliative care cuts costs for metastatic cancer
03/13/24 at 03:00 AMPalliative care cuts costs for metastatic cancer
How NYC Health + Hospitals is reining in travel nurse expenses
03/12/24 at 03:15 AMHow NYC Health + Hospitals is reining in travel nurse expenses Becker's Hospital CFO Report, by Mackenzie Bean; 3/7/24 NYC Health + Hospitals has made progress in decreasing its dependence on travel nurses, though staffing expenditures still exceed the public health system's allocated budget, executives told New York City Council leaders during a preliminary budget hearing March 5.
Smaller wage increases predicted for 2024: survey
03/12/24 at 03:00 AMSmaller wage increases predicted for 2024: surveyMcKnights Senior Living, by Kathleen Steele Gaivin; 3/8/24Wage increases for senior living and care employees are predicted to dip from 4.43% in 2023 to 3.64% this year, according to responses to a newly released Ziegler CFO Hotline survey. The news comes as providers continue to be challenged in recruiting and retaining workers, with compensation as one strategy.
Nursing homes bury 63 percent of profits in related-party tunnels, but not all play the game: study
03/11/24 at 03:00 AMNursing homes bury 63 percent of profits in related-party tunnels, but not all play the game: study McKnights Long-Term Care News, by Josh Henreckson; 3/8/24 As much as 63% of nursing home profits in Illinois were hidden from state regulators using related party transactions in 2019, according to the results of a new study from UCLA and Lehigh University researchers. Those results are likely indicative of a nationwide trend that has continued through the pandemic and into 2024, experts told McKnight’s Long-Term Care News Thursday.
CMS to end Hospice MA Carve-In: Insights for home-based care providers
03/11/24 at 02:00 AMCMS to end Hospice MA Carve-In: Insights for home-based care providers Home Health Care News, by Andrew Donlan; 3/7/24Grand opening, grand closing. Hospice providers began to work with Medicare Advantage (MA) via the Value-Based Insurance Design (VBID) demonstration in 2021. At the end of 2024, the “hospice carve-in” model will cease. ... In this week’s exclusive, members-only HHCN+ Update, I dive into what CMS’ ditching of the hospice carve-in means for home health and hospice providers generally. I’ll also get into what it may mean for that space between home-based care providers and MA plans moving forward.
Health systems invest in productivity
03/08/24 at 03:00 AMHealth systems invest in productivity Becker's Hospital Review, by Laura Dyrda; 3/6/24 Productivity is a buzzword for most workplaces today, and healthcare is no different. U.S. productivity measures showed big increases for the first time in years, according to a report in The New York Times, as organizations leverage artificial intelligence and aim to do more with less. For [health systems], many experiencing staffing shortages and tight margins, developing a culture of increased productivity is imperative.
UnitedHealthcare, Humana, Aetna continue to outgain peers in Medicare Advantage
03/08/24 at 03:00 AMUnitedHealthcare, Humana, Aetna continue to outgain peers in Medicare Advantage Home Health Care News, by Andrew Donlan; 3/6/24In 2023, Medicare Advantage (MA) plan members represented more than half of all Medicare beneficiaries for the first time. In 2024, while penetration continues, there are other trends within MA that home-based care providers should be paying attention to. ... A few of the top companies continue to gain market share. Specifically, UnitedHealth Group (NYSE: UNH), Humana Inc. (NYSE: HUM) and CVS Health (NYSE: CVS) – through Aetna – continue to outpace competitors.
The question of palliative care sustainability
03/08/24 at 03:00 AMThe question of palliative care sustainabilityPalliative Care News, by Holly Vossel; 3/5/24A wide variety of palliative care services have cropped up nationwide in recent years, but not all have remained viable. The forces driving some community-based palliative programs to shutter are two-pronged, related to financial and operational sustainability, according to Renee McInnes, CEO of NVNA & Hospice. Reimbursement and staffing challenges are the most significant factors.
Lower reimbursement a leading cause for poor margins, CFOs say
03/08/24 at 02:45 AMLower reimbursement a leading cause for poor margins, CFOs say Becker's Hospital CFO Report, by Madeline Ashley; 3/6/24 A recent report from the Healthcare Financial Management Association and Eliciting Insights, a healthcare strategy and marketing research company, found that 84% of health systems have cited lower payer reimbursements as a leading cause for low operating margins. [Click on the title's link for six more findings from the report.]
CMS offers relief to providers affected by Change Healthcare outage
03/07/24 at 03:00 AMCMS offers relief to providers affected by Change Healthcare outageModern Healthcare, by Lauren Berryman; 3/5/24The Centers for Medicare and Medicaid Services has rolled out efforts to help providers navigate the Change Healthcare outage disrupting healthcare operations nationwide, the Health and Human Services Department announced Tuesday.Editor's Note: Access to the full article requires a subscription
MA’s cost-management tools may be hurting home healthcare quality, outcomes
03/07/24 at 03:00 AMMA’s cost-management tools may be hurting home healthcare quality, outcomesMcKnights Long-Term Care News, by Adam Healy; 3/5/24Medicare Advantage’s use of cost-reducing tools such as copays, prior authorizations and restricted provider networks may be preventing home healthcare providers from delivering higher-quality care, according to one home healthcare leader.
Understanding the role algorithms play in our lives and navigating palliative care
03/07/24 at 02:00 AMUnderstanding the role algorithms play in our lives and navigating palliative careListen - Life Matters, by Hilary Harper, presenter podcast; 3/4/24Every day, we interact with dozens of algorithms as we go about our lives, but many of us don't understand how they work. How do we get the the best out of these tools while keeping the potential dangers in check?Editor's Note: From palliative care experts Australia; information about algorithms and Artificial Intelligence (AI) transfers to our USA palliative care (of course, without applications to CMS systems).
The current state of community-based palliative care
03/06/24 at 03:00 AMThe current state of community-based palliative careHospice News, by Jim Parker; 3/4/24“Palliative care” is becoming a buzz word in health care, even if many people don’t understand the loosely defined term. However, wide variation exists in how different providers deliver these services in the absence of a standardized, national definition or a more concrete regulatory structure that includes quality measures, Logan Hoover, vice president of policy and public relations for the National Hospice and Palliative Care Organization (NHPCO), said at the Hospice News Palliative Care Conference in Tampa, Florida.
The top strategies healthcare organizations can use to reduce denials
03/06/24 at 03:00 AMThe top strategies healthcare organizations can use to reduce denials MedCityNews, by Laxmi Patel; 3/5/24Here are six actionable steps healthcare organizations can take to reduce their likelihood of denials and write-offs.
Congress floats Medicare physician pay bump: 4 notes
03/05/24 at 03:30 AMCongress floats Medicare physician pay bump: 4 notes Becker's Hospital CFO Report, by Mackenzie Bean; 3/4/24 Physicians are set to receive a 1.7% increase in Medicare pay effective March 9 as part of a $460 billion spending package congressional leaders released this weekend. Four things to know: ... [click on the title's link for more]
Pharmacy associations join forces to advocate for pharmacists during change healthcare outage
03/05/24 at 03:00 AMPharmacy associations join forces to advocate for pharmacists during change healthcare outageNewswire Press Release; 3/3/24 Association executives from the American Pharmacists Association (APhA), the National Community Pharmacists Association (NCPA), the National Alliance of State Pharmacy Associations (NASPA), and the American Society of Consultant Pharmacists (ASCP) released an open letter to pharmacy benefit manager (PBM) executives and other insurance payers whose systems may have been impacted by the Change Healthcare outage. Pharmacists and pharmacies are asking for assurances that claims fulfilled during this outage will be paid, and paid in a timely manner, considering the challenges faced by pharmacies and pharmacists with predicting co-payments and determining eligibility and coverage.
Change Healthcare's temporary funding program 'not even a Band-Aid,' AHA says
03/05/24 at 03:00 AMChange Healthcare's temporary funding program 'not even a Band-Aid,' AHA says Becker's Health IT, by Giles Bruce; 3/4/24 The American Hospital Association called Change Healthcare's temporary funding program for providers affected by the cyberattack on the UnitedHealth Group subsidiary inadequate, while a U.S. Senate leader asked CMS to speed up payments to hospitals. Change Healthcare set up the funding assistance March 1 for providers facing cash-flow issues after losing access to its payer systems, which have been down since the Feb. 21 ransomware attack. However, AHA President and CEO Rick Pollack wrote in a March 4 letter to UnitedHealth Group that the program is "not even a Band-Aid on the payment problems you identify."
Contract CNA staffing associated with worse care quality outcomes: study
03/05/24 at 03:00 AMContract CNA staffing associated with worse care quality outcomes: study McKnights Senior Living, by Kathleen Steele Gaivin; 3/1/24Nursing homes that use contract staffing to fill certified nursing assistant position vacancies are more likely to experience worse care quality than those that do not, according to the results of a study by PHI. The proportion of total CNA hours filled by contract CNAs in SNFs increased from 2% in 2017 to 11% in 2022, the study found.
Home health disparities: Medicare Advantage patients receive fewer visits, worse outcomes
03/05/24 at 02:00 AMHome health disparities: Medicare Advantage patients receive fewer visits, worse outcomes Home Health Care News, by Patirck Filbin; 3/1/24Home health patients under Medicare Advantage (MA) plans have worse functional outcomes compared to traditional Medicare patients, likely as a result of receiving fewer visits, according to a new study.
Double your cybersecurity spending, CIO warns amid Change Healthcare attack
03/04/24 at 03:15 AMDouble your cybersecurity spending, CIO warns amid Change Healthcare attack Becker's Health IT, by Naomi Diaz; 2/29/24What does the Change Healthcare ransomware incident mean for healthcare organizations? Doubling your cybersecurity spending, according to one health system CIO. Will Weider, CIO and senior vice president of Wausau, WI-based Aspirus Health, shared five thoughts on LinkedIn Feb. 29 about the incident, saying, "Whatever you planned to spend to improve cybersecurity, double it." Additionally, Mr. Weider stated that in light of this incident, healthcare organizations should: ...
CMS upends Medicare Advantage supplemental benefits data reporting for payers
03/04/24 at 02:00 AMCMS upends Medicare Advantage supplemental benefits data reporting for payers DLA Piper, by Daivd Kopans and Sua Yoon; 2/27/24 On February 21, 2024, the Centers for Medicare & Medicaid Services (CMS) issued new guidance via a memorandum to Medicare Advantage (MA) organizations, Program of All-Inclusive Care for the Elderly (PACE) organizations, and Demonstration Organizations (collectively, Plans) that upends how these Plans have been reporting (or not reporting) encounter information for their covered supplemental benefits. The guidance in the memorandum is effective retroactively to January 1, 2024. [In this article] is a Q&A explaining the top points of the guidance and highlight its impact on companies across industries.