Literature Review

Alliance official: Medicare Advantage growth, PDGM cuts create converging crises for at-home care Home Health Care News; by Morgan Gonzales; 6/13/25 At-home care is reaching a crisis point, according to Scott Levy, chief government affairs officer  at the National Alliance for Care at Home (the Alliance). The pressure on providers is not only unsustainable – it threatens access to cost-saving in-home care. Already, over one-third of patients referred to home health fail to receive those services. Home health is facing a triple threat, with deepening patient-driven groupings model (PDGM) payment cuts, Medicare rate updates that fail to keep up with real inflation and increased Medicare Advantage (MA) penetration. Meanwhile, home- and community-based services are in the crosshairs of the budget reconciliation bill passed by Congress and now in the Senate’s hands. Access to care is sure to be impacted, Levy said, but questions remain as to what extent. ...

National Alliance: Proposed 2.4% hospice payment update would create shortfall Hospice News; by Jim Parker; 6/11/25 The U.S. Centers for Medicare & Medicaid Services’ (CMS) proposed 2.4% hospice base rate increase is woefully inadequate, and new physician attestation requirements may place undue burdens on providers, according to comments from the National Alliance for Care at Home. The Alliance on Tuesday released its public comments on the 2026 hospice payment rule, which stated that the proposed increase will not adequately cover hospices’ rising costs for supplies, labor, travel and other expenses. 

NPHI proud to announce its partnership on the upcoming documentary for PBS, Caregiving, from Executive Producer Bradley Cooper National Partnership for Healthcare and Hospice Innovation (NPHI), Washington, DC; 5/19/25 The National Partnership for Healthcare and Hospice Innovation (NPHI) is proud to announce its partnership on the upcoming PBS documentary Caregiving, a powerful new film executive produced by Academy Award-nominated actor, director, and producer Bradley Cooper. Created in collaboration with Cooper’s production company, Lea Pictures, as well as WETA Washington, D.C., and Ark Media, Caregiving will shine a national spotlight on the often unseen yet essential work of caregivers across the country. NPHI is honored to serve as a national partner on this important project. Narrated by Uzo Aduba (The Residence, Orange Is the New Black) and directed by Chris Durrance, Caregiving intertwines deeply personal stories of caregivers with the untold history of the American care system. The documentary examines how caregivers—often family members, friends, and frontline professionals—navigate the immense challenges and unseen achievements of their roles.

LeadingAge, Hospice Associations seek delay in HOPE implementation LeadingAge; Press Release; 5/28/25 LeadingAge, along with the National Alliance for Care at Home and the National Partnership for Healthcare and Hospice Innovation, on May 19 urged the Centers for Medicare and Medicaid Services (CMS) to delay implementation of the Hospice Outcomes and Patient Evaluation, or HOPE tool. In the letter to CMS Administrator Dr. Mehmet Oz the associations outline concerns with technology implementation in preparation for the HOPE tool. The letter specifically asks CMS to waive the HOPE timeliness submission requirement for two calendar quarters post implementation. The letter further requests that CMS delay the HOPE implementation date until at least six months after CMS education, training, and final validation specifications are available and the application for iQIES access has been opened for hospices. 

Remove barriers that restrict hospice care, Alliance offers in new report McKnights Home Care; by Adam Healy; 5/28/25 Hospice providers can boost quality and patient satisfaction with a focus on transparent, culturally sensitive communication with clients, according to a new report by the National Alliance for Care at Home. ... For the report, the Alliance surveyed 2,000 adults who either recently experienced the death of a loved one or have been involved in healthcare decisionmaking for a person with a serious illness. Respondents included individuals of a variety of ages, income levels, ethnicities and educational backgrounds. ... . For many seniors, one of the largest barriers to care is ineffective communication, the survey found. Language barriers are a significant hurdle for non-English speaking older adults, particularly those who are first generation immigrants, it noted. Many seniors are also less comfortable with technology-based communication than younger people, and prefer face-to-face conversation over text messages.

ALS and mental health: The importance of caring for the whole person ALS Association; by Amber Johnstone, MSW, LISW-S; retrieved from the internet 5/27/25 ... May is ALS Awareness Month and also Mental Health Awareness month. ALS and Mental Health go hand in hand. One of the first things I tell newly diagnosed individuals that I work with is that ALS affects the whole family. And to be truthful, it affects many more than just that nuclear family unit. A person living with ALS is like a pebble thrown into a pond. That first splash is the biggest, but then the water ripples all the way out to the edges of the pond. Those ripples are all the people with which the person with ALS shares their journey. ... The ALS Association understands how important mental health can be.  ... The ALS Association is proud to offer ALS Academy to community healthcare professionals and caregivers.  ALS Academy is free, online, self-paced, catalog of ALS education videos.  

Alliance, Aetna & MissionCare collective unite to strengthen direct care workforce HomeCare, Alexandria, VA and Washington, DC; Press Release; 5/19/25 The National Alliance for Care at Home (The Alliance), Aetna Medicaid, a CVS Health company, and MissionCare Collective have begun a collaborative effort to increase access to home health care for older adults and those with disabilities, and increase supports for direct care workers in Illinois, Louisiana and North Carolina. Initially launching in Illinois, Louisiana and North Carolina, the pilot program is funded by Aetna and brings together two national providers committed to transforming care delivery at home. The Alliance represents providers across homecare, home health, hospice and palliative services, serving as an advocate for care delivered where people live. MissionCare Collective, a workforce innovation provider, offers a suite of solutions designed to build, retain and support the care workforce at scale.

The evolution of hospice care The Journal; by Dr. Sarah Phillips, Medical Director, Hospice of the Panhandle; 5/18/25 Historians believe that the first hospices originated in Malta around 1065, dedicated to caring for the ill and dying enroute to and from the Holy Land. The term “hospice” referred to places of shelter for travelers, particularly in medieval Europe. The moder hospice movement began to gain momentum in the 1960’s with Dame Cicely Saunders’s establishment of St. Christopher’s Hospice in London, which emphasized comfort and quality of life for patients and their families. This idea of specialized care for the dying was first introduced to the United States during a lecture at Yale University in 1963. In the early 1970’s the first national hearings on the subject of death with dignity were conducted by the U.S. Senate Special Committee on Aging. In 1978, the National Hospice Organization was established and the U.S. Department of Health, Education, and Welfare task force reports that “the hospice movement … is a viable concept and one which holds out a means of providing more humane care for Americans dying of terminal illness while possibly reducing costs. As such, it is the proper subject of federal support.” [Continue reading ...]

Palliative and end-of-life care during critical cardiovascular illness: A scientific statement from the American Heart Association American Heart Association; by Erin A. Bohula, MD, DPhil, Michael J. Landzberg, MD, Venu Menon, MD, FAHA, Carlos L. Alviar, MD, Gregory W. Barsness, MD, FAHA, Daniela R. Crousillat, MD, Nelia Jain, MD, MA, Robert Page II, PharmD, MSPH, FAHA, Rachel Wells, PhD, MSN, and Abdulla A. Damluji, MD, PhD, MBA, FAHA on behalf of the American Heart Association Acute Cardiac Care and General Cardiology Committee of the Council on Clinical Cardiology; and Council on Cardiovascular and Stroke Nursing; 5/15/25 Abstract: Cardiac intensive care units are witnessing a demographic shift, characterized by patients with increasingly complex or end-stage cardiovascular disease with a greater burden of concomitant comorbid noncardiovascular disease. Despite technical advances in care that may be offered, many critically ill cardiovascular patients will nevertheless experience significant morbidity and mortality during the acute decompensation, including physical and psychological suffering. Palliative care, with its specialized focus on alleviating suffering, aligns treatments with patient and caregiver values and improves overall care planning. Integrating palliative care into cardiovascular disease management extends the therapeutic approach beyond life-sustaining measures to encompass life-enhancing goals, addressing the physical, emotional, psychosocial, and spiritual needs of critically ill patients. This American Heart Association scientific statement aims to explore the definitions and conceptual framework of palliative care and to suggest strategies to integrate palliative care principles into the management of patients with critical cardiovascular illness.

National Alliance: Medicaid cuts would adversely impact home-, community-based services Hospice News; by Jim Parker; 5/12/25 A tax bill currently before Congress could lead to Medicaid cuts that would inhibit access to home- and community-based services (HCBS). The bill, which promises sweeping tax and spending cuts, currently is undergoing a reconciliation process. The amount of tax cuts could reach $4.5 trillion, with spending cuts in the area of $4.5 billion, with a significant portion coming from Medicaid. However, the bill remains a work in progress for now with some resistance to the proposed cuts from both Democrats and a contingent of Republicans. The National Alliance for Care at Home released a statement Monday opposing the Medicaid reductions.

National Alliance for Care at Home unveils new website to enhance member experience The National Alliance for Care at Home, Washington, DC; Press Release; 5/5/25 The National Alliance for Care at Home (the Alliance), the leading advocate and educator for the care at home community, is proud to announce the launch of its newly redesigned website, AllianceForCareAtHome.org. The new site reflects the Alliance’s commitment to innovation, accessibility, and delivering enhanced value to member organizations and all care at home stakeholders. ... “We’re excited to introduce our new website as a digital reflection of who we are and where the Alliance is headed,” said CEO Dr. Steve Landers. ... Key features of the new website include:

NPHI Honors Visionary Leaders and Organizations at 2025 Annual Summit: The National