Literature Review

Do automated reminders decrease no-show visits in an outpatient palliative medicine clinic? Sage Journals - American Journal of Hospice and Palliative Medicine; by Ruth L. Lagman, MD, MPH, MBA, Renato V. Samala, MD, MHPE, Ahed Makhoul, MD, Kyle Neale, DO, Chirag Patel, MD, Elizabeth Weinstein, MD, Wei Wei, MS, and Xiaoying Chen, MS; 3/23/25 Individuals who do not show up for medical appointments can lead to unfavorable outcomes for both patients and health systems. Automated methods are available to confirm appointments in addition to patient service coordinator (PSC) telephone calls. This study aims to determine the no-show rates for automated methods of confirmation, in-person and virtual visits, and patients living in underserved areas.Conclusion: PSC telephone calls, individuals living within COZ and virtual visits had higher no-show rates.

The COVID mistake no one talks enough about The Atlantic; by Sunita Puri; 3/25/25 Deaths in isolation have been treated as a painful memory, not as a problem that hospitals need to address. He was one of the few ICU patients whose face I saw in early 2021, when COVID raged through Los Angeles. As a palliative-care physician, my job was to meet, over Zoom, with the families of intubated patients to ensure that they had complete medical updates and to help them make difficult medical decisions on behalf of their loved one, particularly when that person faced death. But in a surreal departure from my usual practice, I’d never once seen these patients myself: At the time, to minimize exposure to COVID, the only people permitted to enter the ICU regularly were members of the ICU team. ... His wife told me that during his many previous illnesses, she had slept every night in his hospital room, making sure he asked for pain medications and watching movies with him to pass the time. “He fought harder to live when I was there,” she told me. [Continue reading ... full access may require a free trial or subscription]

Community health workers and technology interventions' impact on palliative support globally Journal of Palliative Medicine; by Alekhya Gunturi, Margarita Pertierra, Irma Elizabeth Huayanay Espinoza, Maya Kavita Ramachandran, Mpho Ratshikana Moloko, Karl A Lorenz; 3/20/25Background: Palliative care has the potential to relieve burdened global health systems but is in short supply in many low-resource settings. Community health workers (CHWs) and digital health tools/telephonic support have the potential to scale scarce palliative care resources and improve outcomes for seriously ill adults in home/community settings.  Conclusions: CHWs and digital health/telephony can improve quality of life, health care use, and caregiver support. Most research focuses on physical and psychological aspects of care instead of cultural aspects of care. Future research is needed to explore culturally tailored interventions in minority populations and low- and middle-income countries, as well as investigate emerging remote technologies to allow for scaling palliative care into home/community settings.Editor's note: Pair this with Hospice community responds to proposed DEA telehealth prescribing rule, posted 3/21/25.

Congress extends telehealth flexibilities: 5 notes Becker's Health IT; by Naomi Diaz; 3/17/25 Congress has passed a federal spending bill that extends telehealth provisions through Sept. 30, 2025. ... Here are five key telehealth-related elements of the bill:

The Alliance commends introduction of legislation to extend hospice telehealth flexibilities  National Alliance for Care at Home, Alexandria, VA and Washington, DC; Press Release; 2/28/25 The National Alliance for Care at Home (the Alliance) is pleased to support the reintroduction of the Hospice Recertification Flexibility Act in the House of Representatives. This bipartisan legislation, H.R.1720, would extend telehealth flexibilities for hospice face-to-face (F2F) recertification. The F2F encounter is performed by a physician or nurse practitioner to evaluate the patient and collect clinical information used in determining continued eligibility for hospice. Introduced by Representatives Carol Miller (R-WV) and Jared Golden (D-ME), the bill would extend the F2F recertification flexibility for providers until December 31, 2027. Beginning January 1, 2026, the legislation also includes important guardrails to ensure appropriate use and requires the Centers for Medicare & Medicaid Services (CMS) to create a modifier to collect data on when the F2F encounter is conducted via telehealth. The Alliance, then through its legacy organizations, worked with lawmakers to ensure continued care transformation and access to care for high-quality providers. [Click on the title's link to continue reading.]

New telehealth rules: 5 takeaways on temporary flexibilities for 2025 Becker's ASC Review; in collaboration with Coronis Health; 1/21/25 With the passage of the American Relief Act, 2025, certain telehealth flexibilities initially introduced during the public health emergency (PHE) era have been extended. These provisions, however, are only authorized through March 31, 2025. A Jan. 9 blog post by Coronis Health breaks down what the extensions mean for telehealth providers and patients, what services and features were left out and why certain changes could become permanent in 2025. Five takeaways:

[Cure] Top palliative care stories from 2024 Cure; by Alex Biese; 12/28/24 This year, CURE® worked to provide education and insight that underscored the importance of palliative care in cancer treatment. Early integration of palliative care, whether through in-person visits, telehealth or ongoing emotional support, can make a significant difference in a patient's quality of life. Here are some of the top articles on the topic of palliative care from 2024.

Hospital-at-home, telehealth, DME reimbursement top year-end home care priorities McKnights Home Care; by Adam Healy; 12/9/24 Home care advocates are advancing numerous home care advocacy priorities in the final days of 2024. They are focusing on telehealth, hospital-at-home and durable medical equipment (DME). Last week, the Long-Term Post-Acute Care Health Information Technology (LTPAC Health IT) Collaborative, which includes LeadingAge as a member, sent a letter to Congress asking for an extension of telehealth flexibilities enacted during the COVID-19 pandemic. These flexibilities, which allow providers to furnish virtual care services over state lines, among other capabilities, will expire Dec. 31 without congressional action.

Regulators extend some telemedicine flexibilities, gauge telehealth’s ‘new path forward’ in hospice Hospice News; by Holly Vossel; 12/4/24 Regulators recently extended certain temporary telemedicine waivers granted during the pandemic, with some flexibilities now sunsetting in 2025 rather than the end of this year. The U.S. Drug Enforcement Administration (DEA) and the U.S. Department of Health and Human Services (HHS) have announced the extension of telemedicine flexibilities for the prescribing of controlled medications until Dec. 31, 2025. ... The move was made in response to feedback the agencies received from more than 38,000 comments and two days of public listening sessions. The extension allows for more time to consider a “new path forward” for telemedicine, according to the DEA and HHS. “We continue to carefully consider the input received and are working to promulgate a final set of telemedicine regulations,” the agencies stated in an announcement. “With the end of 2024 quickly approaching, DEA, jointly with HHS, has extended current telemedicine flexibilities through December 31, 2025.” The temporary rule, entitled as the Third Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications, was recently submitted to the Federal Register and will take effect/become effective Jan. 1, 2025.

Virtual nursing results at 8 systems: 24 stats to know Becker's Clinical Leadership; by Paige Twenter; 11/4/24 Faced with a shortage of nurses, a rise in high-acuity cases and an increase in labor spend, hospitals and health systems have turned to virtual nursing programs for solutions. Here are 24 statistics tied to virtual nursing models, according to Becker's reporting:

CMS finalizes 2.9% cut in physician payments for 2025, including for palliative care Hospice News; by Jim Parker; 11/4/24 The U.S. Centers for Medicare & Medicaid Services (CMS) has finalized a nearly 2.9% cut for 2025 in physician payment rates used to reimburse palliative care care practitioners, among other professionals. The final rule also states that the telehealth flexibilities implemented during the COVID-19 public health emergency will expire at the end of this year unless Congress intervenes. Physicians and other professionals will have to follow pre-COVID restrictions on telehealth, with few exceptions. Industry organizations were quick to denounce the pay cut. “To put it bluntly, Medicare plans to pay us less while costs go up. You don’t have to be an economist to know that is an unsustainable trend, though one that has been going on for decades,” American Medical Association President Dr. Bruce Scott said in a statement.

Delivering palliative care by telehealth meets the needs of people with cancer National Institutes of Health (NIH) - National Cancer Institute; by Linda Wang; 10/28/24 The use of telehealth in cancer care surged during the COVID-19 pandemic, when, for a period of time, in-person medical care was limited and many visits to the doctor went virtual. Despite some recent pullbacks in telehealth flexibilities, many experts believe that telehealth will continue to have a role in cancer care. But how well does telehealth perform when it comes to delivering palliative care for people with cancer, which can rely on a deeper level of connection between patients and providers than may be possible with a virtual visit? A study of 1,250 people with advanced lung cancer has now provided some insights into that question. The study found that virtual and in-person palliative care were similarly effective in improving patients’ quality of life and other important measures of well-being, according to findings published September 11 in JAMA. It also found benefits for caregivers. The results show that “we can successfully deliver … high-quality [palliative] care in person and virtually,” said Joseph A. Greer, Ph.D., of Massachusetts General Hospital, who led the study. 

MD Home Health expands services with in-clinic, virtual care, remote patient monitoring, house calls and hospice Longview News-Journal, Phoenix, AZ; by MD Home Health; 10/15/24 Leading Home Health Agency in Arizona launches comprehensive onmnichannel healthcare approach. MD Home Health, a privately-held leading Arizona-based home health agency, today announced the expansion of its healthcare services to include in-clinic care, virtual care, remote patient monitoring, house calls, and hospice, making it one of the first privately-held home health agencies in Arizona to offer a full and comprehensive omnichannel healthcare approach. This expansion allows the firm to broaden its healthcare offering to significantly increase access to comprehensive, quality and convenient healthcare for residents across the Phoenix metro area. "Our new and comprehensive services are designed to ensure that patients have convenient and flexible options to access quality healthcare how, when and where they need it," said David P. Tusa, President and Chief Executive Officer of MD Home Health.