Literature Review

Telehealth use among seniors back up to pandemic-era highs, one company claimsMcKnight’s Senior LivingDecember 13, 2023Nearly all seniors in the US, an astonishing 97%, had at least one telehealth appointment this year, a new survey indicates. The data, which comes from remote platform operator Independa, indicates that telehealth usage among seniors has grown 20% over the past three years, nearly back up to the pandemic-era peak, when in-person options were not available. 

2023 NHPCO Facts and Figures Report Now AvailableNews ReleaseDecember 13, 2023Alexandria, VA—The National Hospice and Palliative Care Organization has published its 2023 edition of Facts and Figures, an annual report on key data points related to the delivery of hospice care, including information on patient characteristics, location and level of care, Medicare hospice spending, and hospice providers. NHPCO Facts and Figures is the leading resource for hospice providers and others interested in understanding the work of the community. Editor's Note: Click here to access NHPCO's Report

Fix needed now—America’s long-term care financing system is brokenBy Katie Smith SloanThe HillDecember 11, 2023Nonprofit providers of aging services have been warning for decades that America’s system for financing long-term care is dangerously broken. The dedicated professionals serving older adults in nursing homes, home health agencies, hospice programs, and senior living communities have toiled side-by-side with families across the country to cobble together care and services for parents, friends, and neighbors—connecting the tattered pieces of our patchwork long-term care system in an effort to ensure dignity, comfort and independence as the needs of our loved ones change. The New York Times KFF Health News’ series “Dying Broke” aptly illustrates the impact of the United States’ insufficient approach to financing of long-term services and supports. It’s an important and unflinching look at how our country is failing us. ... We can do better. A comprehensive and equitable long-term care financing system would make all the difference. The longer lives that many Americans will enjoy offers enormous potential for our nation. We must seize this opportunity and ensure that potential isn’t squelched by an oppressive and unfair long-term care financing system. The solutions are complicated—but smart approaches abound. The variable is political will. ... I urge our leaders to listen to the voices of their constituents, and join us in creating solutions. All of our futures depend on it.

Kansas’ unrivaled rural hospital crisis—58% at risk of closing, 82% lost money on patient careKansas ReflectorDecember 12, 2023Topeka, KS—Financial weaknesses at four of every five rural Kansas hospitals provide leverage to Medicaid expansion advocates who are eager for the infusion of $680 million annually in new government investment into the state’s health care system. The Center for Healthcare Quality and Payment Reform says 84 of the state’s 102 rural hospitals recorded financial losses on patient services in the most recent year data is available. The health policy organization reports 59 of the state’s rural hospitals are in jeopardy of closing. Twenty-eight are at immediate risk of collapse. A health care delivery calamity has been building for years, as 10 of Kansas’ rural hospitals closed since 2005. ... “How much more evidence do we need that rural communities need our support to keep health care affordable and accessible?” said Democratic Gov. Laura Kelly. Kelly said expansion of Medicaid eligibility to about 150,000 lower-income Kansans will narrow coverage gaps and throw a lifeline to hospitals and communities. ... “We can only judge the impact of not expanding Medicaid by looking at the states around us that have,” Kelly said. ... Administrators at hospitals in Kansas are urging lawmakers to break from the 10 Southern and rural states that—so far—reject Medicaid expansion.

In letter to CMS, lawmakers call for more MA transparencyMcKnight’s Home Care DailyDecember 11, 2023Four senators demanded the Centers for Medicare & Medicaid Services make more data surrounding prior authorizations in Medicare Advantage publicly available. “In the last few years, federal watchdogs have released numerous reports examining concerning trends in MA,” Sens. Bill Cassidy, MD (R-LA), Elizabeth Warren (D-MA), Marsha Blackburn (R-TN) and Catherine Cortez Masto (D-NV), the letter’s signees, said in a statement. “Without publicly available plan-level data ... policymakers and regulators are unable to adequately oversee the program and legislate potential reforms.” The senators specifically requested CMS gather and publish data regarding prior authorization requests, denials and appeals, justifications for denials and the timeliness of prior authorization decisions. 

NJ extends Medicaid palliative care for poor and elderlyNJ Spotlight NewsDecember 7, 2023New Jersey plans to expand health insurance coverage so that low-income residents with a serious advanced illness can get pain relief and other palliative care at home, regardless of their prognosis, or if they live independently, in a nursing home or assisted living. The state Assembly is expected to take a final vote Thursday on bipartisan legislation that adds community-based palliative care—including specialized medical treatment, emotional and spiritual support and other services to improve patients’ quality of life—to the list of benefits Medicaid will pay for in New Jersey. 

The Medicare Gold Rush Is Slowing DownWall Street JournalDecember 6, 2023The popularity of private Medicare plans has been a huge driver of profits for insurance companies in recent years. There are signs the gold rush isn’t quite what it once was. ... The most immediate red flag came from the industry leader, UnitedHealth. During an investor day last week, it predicted its Medicare Advantage enrollment would grow by 450,000 to 550,000 seniors in 2024. That translates to around 5% growth next year, a significant slowdown from the 11% it grew so far this year, according to TD Cowen analyst Gary Taylor. As UnitedHealth executives were presenting in New York, The Wall Street Journal reported that the second-largest Medicare plan provider, Humana, was in merger talks with Cigna. While Cigna’s interest in Humana surely attests to insurers’ continued desire to expand into the Medicare market, some investors took it as a sign that Humana isn’t so sure about the strength of the business going forward. 

How Value-Based Care, Investors Could Impact Palliative Care StaffingPalliative Care NewsDecember 4, 2023Interest in palliative care is rising among job-seeking clinicians, but the influx remains too slow to meet rising demand. ... Though far more resources are needed, more opportunities for clinical palliative care training have been emerging in recent years, according to Dr. Nathan Goldstein, currently professor of geriatrics and palliative medicine at Icahn School of Medicine at Mount Sinai.