Literature Review

The politics of loss: What grief reveals Psychology Today; by Daniela E. Miranda, PhD; 12/10/24 It has been a bit over two years since my 27-year-old brother unexpectedly passed away, exactly two weeks before my 64-year-old father, quickly and expectedly, died from cancer. What followed was a series of “secondary losses”. For my family, secondary losses included the shifting dynamics of caregiving and the emotional labor required to rebuild a daily life after multiple losses, while permanently uprooting to a different country. This article is not about my grief but about how the experience of loss can illuminate the fractures and possibilities within our systems of care. ... Key points:

Don’t let CMS publish list of lowest-performing hospices, Alliance tells lawmakers McKnights Home Care; by Liza Berger; 11/26/24 Acting on its plan to keep the hospice Special Focus Program in the spotlight until the end of the year, the National Alliance for Care at Home has sent congressional leaders a letter urging them to remedy the grading system for the Centers for Medicare & Medicaid Services’ program targeting underperforming hospices. “CMS is on the verge of publishing a list of what they claim will be poor-performing hospices based on this flawed grading system,” Ken Albert, president and CEO of Andwell Health Partners and chair of the Alliance, wrote in a Nov. 22 letter to chairmen and ranking members of House and Senate finance committees. “When you see this list, you should view it skeptically, because CMS will have committed a grave error that risks steering patients away from reputable hospices that may be on the list and toward providers that — because they may not have been surveyed at all — could be low-quality or completely fraudulent.”

Pursuit of quick profits makes hospice care worse, new research says Ohio Capital Journal; by Marty Schladen; 11/20/24 Private equity firms — high-dollar investors known for aggressively seeking profit — and publicly traded health conglomerates have been buying up businesses that provide hospice care. But when it comes to caring for patients facing the end of their lives, those businesses perform worst, according to a research letter published Monday in the Journal of the American Medical Association. ...  Publicly traded behemoths such as UnitedHealth Group and CVS Health are already the subject of investigations and lawsuits by federal and state government over allegedly anticompetitive actions as drug middlemen. At the same time, both provide hospice care. Meanwhile, the business practices of private equity groups have been coming under increasing scrutiny over the past decade. They often buy businesses in deals structured so they can quickly recoup their investment, identify the most profitable assets, sell them and then sell the resulting business or declare bankruptcy. ... The firms also have been accused of being predatory toward consumers.

For-profit hospices increasing despite poor performance EurekAlert!, Weill Cornell Medicine; Peer-reviewed publication; 11/18/24 Hospices are increasingly owned by private equity firms and publicly traded companies, but recently Weill Cornell Medicine researchers found that they performed substantially worse than hospices owned by not-for-profit agencies. This is concerning as nearly 75% of hospice programs, which care for patients in their last stage of life, are for-profit. The study, published Nov. 18 in JAMA, highlights the need for policy interventions that focus on increasing transparency and accountability in hospice ownership. ... The researchers analyzed Consumer Assessment of Health Care Providers and Systems (CAHPS) data from January 2021 through December 2022. CAHPS, the national standard for assessing the quality of patient care, surveyed the caregivers of those who passed away in hospice by telephone and mail. The researchers compared measures for communication, timely care, treating family members with respect, emotional and religious support, help for symptoms, hospice care training, hospice rating and willingness to recommend. ... Of the 2,676 hospices included in the final analysis, approximately 25% were owned by private equity and publicly traded companies and 40% were other types of privately owned for-profit hospices. Though only 25% of the hospices surveyed were not-for-profit, they provided the highest-rated quality care including focus on managing pain, comfort, dignity and quality of life.

Hospices improving on public measures Home Health Line - decisionhealth; by DecisionHealth Staff; 9/12/24 Hospice providers are seeing continued improvement on key measures in the Hospice Item Set, according to the latest refresh of Care Compare data on Aug. 28, 2024. [Subscription required] Editor's note: Use this summary information to check your own CMS Hospice Compare Scores at Find Healthcare Providers: Compare Care Near You | Medicare. Select Provider Type "Hospice Care." Type your location or "Name of Agency" and "Search." Select your hospice. For the Hospice Item Set (HIS), scroll down to "Quality" - "Quality of patient care." For your CAHPS data, scroll down to "Family caregiver experience."

Perfecting healthcare’s 360° consumer-centric strategy Guidehouse; 8/13/24 To ably compete in today’s healthcare environment while meeting their mission of quality patient care, health systems must make patient access and the consumer experience a core value across their entire organization. That means placing a relentless focus on reducing friction to meet customer expectations and aligning people and tech resources with standardization and scale. ... 

Hospice groups to CMS: Don’t rush CAHPS changes Hospice News; by Jim Parker; 6/3/24Hospice industry organizations have voiced support for proposed updates to the Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys, but raised questions on the implementation timeline. ... One key concern about the timeline is the need for vendors to develop updated electronic medical record (EMR) systems as well as methods of collecting the data, according to Katy Barnett, director of home care and hospice operations for LeadingAge. ... The proposed changes include:

Hospice CAHPS scores updated 5/22/24CMS CAHPS® website; multiple updates posted 5/22/24 CMS has posted numerous CAHPS® Hospice Survey updates. Click on the title's link to access the CMS site. Click on "Care Compare Reporting Updates" or the following 5/22/24 updates: