Literature Review

National Health Expenditures 2022 HighlightsCMS Fact Sheet, 12/13/23U.S. health care spending grew 4.1% to reach $4.5 trillion in 2022, faster than the increase of 3.2% in 2021, but much slower than the rate of 10.6% in 2020. The growth in 2022 reflected strong growth in Medicaid and private health insurance spending that was somewhat offset by continued declines in supplemental funding by the federal government associated with the COVID-19 pandemic. 

Falling short—99% of Mississippi nursing homes don’t meet new staffing regsMississippi TodayDecember 13, 2023... In Mississippi, all but two of the 200 skilled nursing facilities—those licensed to provide medical care from registered nurses—would need to increase staffing levels under federal regulations the Biden administration proposed in September, according to data analyzed by Mississippi Today, USA TODAY and Big Local News at Stanford University. That’s in line with the national trend: Over the first quarter of 2023—from January to March—less than 1% of skilled nursing facilities in the U.S. met the draft rule’s two core standards of provider care. 

Proportion of hospice users declines while industry undergoes shift, NHPCO report findsMcKnight’s Home Care DailyDecember 14, 2023The proportion of Medicare beneficiaries who died on hospice continued to decline in 2021, according to the National Hospice and Palliative Care Organization’s 2023 Fact and Figures report. ... Notably, the number of hospice users rose by thousands since 2019, but this growth was unable to outpace the proportion of Medicare beneficiaries who died without receiving any hospice care. 

Memory Care Gap—GAO Report Shows Less than 2.5% of Medicare Beneficiaries with Alzheimer’s Receive Cognitive AssessmentSenior Housing NewsDecember 13, 2023Between 2018 and last year, use of cognitive assessment and care plan services tripled, but few Medicare beneficiaries who qualify received the service, according to a recent study by the Government Accountability Office. The GAO study found that, at most, 2.4% of Medicare beneficiaries with a diagnosis of Alzheimer’s disease or a related disorder received this service. 

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

MedPAC draws fire with draft recommendations for massive home health cut, hospice rate freezeMcKnight’s Home Care DailyDecember 12, 2023The Medicare Payment Advisory Commission offered initial recommendations for Congress to cut home health reimbursement by 7% and pause hospice payment updates in 2025. “The 2022 [home health] margins remain above 20%, higher than the long-run average of 16.8% since 2001,” Evan Christman, senior analyst at MedPAC, said during last Friday’s public meeting, according to a transcript. “Overall, these margins indicate that Medicare fee-for-service continues to pay well in excess of cost.” Part of the reason home health agencies reportedly saw margins of 22.2%, on average, according to Christman, is a decline in the number of visits per 30-day period. Since the implementation of the Patient-Driven Groupings Model in 2020, these visits have declined more than 15%; between 2021 and 2022, visits per 30 days declined 3.5%. Home health advocates were quick to dispute MedPAC’s claims. “There are many shortfalls in MedPAC’s home health margins report—starting with the fact that MedPAC’s analysis only captures a declining fraction of the Medicare home health population, ignoring that overall margins are low,” Joanne Cunningham, chief executive officer of the Partnership for Quality Home Healthcare, said in a statement. ... The Partnership and National Association for Home Care & Hospice cited poor methodology and data in the recent home health final rule, which contained a Medicare cut related to PDGM. MedPAC also recommended that Congress eliminate any payment updates for hospice providers in 2025. 

UnitedHealth hit with Medicare Advantage marketing complaintModern HealthcareDecember 7, 2023Advocates for people with disabilities are calling on regulators [to] halt what they describe as misleading Medicare Advantage marketing by UnitedHealth Group. The Center for Medicare Advocacy, National Health Law Program, Disability Rights Connecticut and National Disability Rights Network wrote the Centers for Medicare and Medicaid Services, the Federal Trade Commission and other state and federal officials Thursday to protest UnitedHealthcare advertisements for Dual Eligible Special Needs Plans appearing in Connecticut. The ads target people with both Medicare and Medicaid and spotlight extra benefits from Medicare Advantage plans that state and federal laws already require, the groups wrote. “Unquestionably, this misleading advertising is intended to induce, and has induced, thousands if not tens of thousands of older adults and disabled low-income individuals we are charged with representing to sign up for UnitedHealthcare’s plan, having been led to believe this means they can get extra benefits,” the letter says. UnitedHealth Group did not immediately respond to an interview request.

Here’s why you can’t die peacefully in Oklahoma.By Abby RemmingThe OklahomanDecember 6, 2023... Having Medicare or a Medicare Advantage plan would cover hospice, but many people have private insurance from work or state Medicaid plans. Private insurance and Medicaid Advantage plans at times can have a hospice benefit but limit which companies can be used. Applying for Medicare will ensure you are covered for hospice. ... I currently work as a hospital social worker and assist many people who need hospice. Many times, I have had to share with patients and their families that, while they may be ready to peacefully pass away, hospice coverage is not included in the patient’s current insurance plan. Providing end-of-life care is extremely difficult without the added burden of worrying whether insurance will cover the benefit. Those without the benefit and who need the service are then reliant upon the generosity of the companies to absorb the cost. If the Medicaid Advantage plan is picked, a person would need to decide if they wanted the benefit to either cover nursing home care or in-home hospice care. A Medicaid Advantage plan might not cover hospice even when the policyholder believes they have the benefit.