Literature Review

Mass layoffs hit workers at HHS; sweeping cuts extend to CDC, NIH, FDA: Recap USA Today; by Sarah D. Wire, Josh Meyer, Bart Jansen, Ken Alltucker, Cybele Mayes-Osterman, Eduardo Cuevas, Sudiksha Kochi, Adrianna Rodriguez and Terry Collins; 4/1/25Mass layoffs began Tuesday at the Centers for Disease Control and Prevention and at the Food and Drug Administration, the first steps in a plan to cut 10,000 jobs at the Department of Health and Human Services. The department responsible for overseeing protection for Americans' health, food and drug supplies and Medicare and Medicaid is also closing its internal agencies that are focused on older adults and people with disabilities. It's also getting rid of its offices tackling HIV and improving minority health. Staff had to present their badges at the building entrance and those who had been fired were given a ticket and told to return home. More than 100,000 federal workers have already lost their jobs in the last two months as part of President Donald Trump and billionaire Elon Musk's efforts to shrink staffing levels in federal departments and agencies. Tens of thousands more are expected as more agencies implement their reduction in force, or RIF, plans in the coming weeks.

Walgreens settles Illinois Medicaid fraud lawsuit for $5M Modern Healthcare; by Katherine Davis; 3/25/25 Walgreens Boots Alliance will pay $5 million to settle allegations that it violated U.S. and Illinois false claims statutes by improperly billing Medicaid and Medicare. The settlement, disclosed in court filings [3/24], marks the end of the dispute, which began 11 years ago when two whistleblowers claimed Walgreens’ practices violated statutes. ... The settlement, disclosed in court filings yesterday, marks the end of the dispute, which began 11 years ago when two whistleblowers claimed Walgreens’ practices violated statutes. ... The settlement funds will be divided among the U.S. government, the state of Illinois and the whistleblowers, according to court filings. All parties also filed a joint stipulation of dismissal yesterday. Walgreens declined to comment. [Continue reading; access to the full article may be limited to subscription ...]

Evaluation of the Medicare Advantage Value-Based Insurance Design model test: 2020 to 2023  RAND Health Care, prepared for the Centers for Medicare & Medicaid Services Center for Medicare and Medicaid Innovation Under Research, Measurement, Assessment, Design, and Analysis Contract Number 75FCMC19D0093, Order Number 75FCMC20F0001; by Christine Eibner, Dmitry Khodyakov, Erin A. Taylor, Denis Agniel, Rebecca Anhang Price, Julia Bandini, Marika Booth, Lane F. Burgette, Christine Buttorff, Catherine C. Cohen, Stephanie Dellva, Michael Dworsky, Natalie C. Ernecoff, Alice Y. Kim, Julie Lai, Monique Martineau, Nabeel Qureshi, Afshin Rastegar, Max Rubinstein, Daniel Schwam, Joan M. Teno, Anagha Tolpadi, Shiyuan Zhang; March 2025 This report presents RAND researchers’ findings from their evaluation of the Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model test for 2020 through 2023, initiated by the Center for Medicare and Medicaid Innovation (Innovation Center). The VBID Model allows participating MA parent organizations (POs) to offer supplemental benefits, financial and nonfinancial incentives to beneficiaries, hospice benefits (the Medicare Hospice Benefit, Palliative Care, Transitional Concurrent Care, and Hospice Supplemental Benefits), and Wellness and Health Care Planning through their MA plans.

Kennedy slashing 10,000 jobs in health department overhaul USA Today, Washington, DC; by Joey Garrison; 3/27/25 Health and Human Secretary Robert F. Kennedy Jr. said Thursday he will cut about 10,000 full-time jobs from the Cabinet department in a dramatic reduction that includes closing half its regional offices as part of a wider Trump administration overhaul of the federal government. Combined with HHS employees who previously accepted buyouts and others who were already fired, the agency's workforce will be sliced by one-quarter from 82,000 full-time employees to 62,000 since President Donald Trump returned to the White House. The Department of Health and Human Services ‒ which oversees the Centers for Disease Control and Prevention and Centers for Medicare and Medicaid Services ‒ will consolidate the agency's 28 divisions into 15 new divisions in Kennedy's shakeup. ... Among the cuts in key divisions:

Trump’s first 60 days: The impact on the home health industry Home Health News; by Audrie Martin; 3/20/25 Tax, immigration and diversity, equity and inclusion policies are some of the top-of-mind regulatory concerns for home health agencies in 2025. The first 60 days of the Trump Administration and their impact on the home health care industry were highlighted during a webinar hosted by the Polsinelli Law Firm on Thursday. National Alliance for Care at Home CEO Steve Landers and Home Care Association of America (HCAOA) CEO Jason Lee joined representatives from Polsinelli to discuss potential Medicaid cuts, the importance of extending telehealth services, and the need for workforce expansion. The webinar also explored how executive orders and administrative actions are affecting home care and hospice services. [Click on the title's link to continue reading.]

Oz does not rule out Medicaid cuts during Senate confirmation hearing McKnights Home Care; by Adam Healy; 3/14/25 Mehmet Oz, MD, President Donald Trump’s pick to lead the Centers for Medicare & Medicaid Services, did not give a direct answer when asked whether he was for or against Medicaid cuts Friday during a Senate Finance Committee hearing. “I cherish Medicaid and I’ve worked within the Medicaid environment quite extensively practicing at Columbia University,” Oz said when asked by Sen. Ron Wyden (D-OR) if he would oppose cuts to Medicaid. “I want to make sure that patients today and in the future have resources to protect them if they get ill. The way you protect Medicaid is by making sure it’s viable at every level, which includes having enough practitioners to afford the services, paying them enough to do what you request of them, and making sure that patients are able to actually use Medicaid.”

What Trump has done with Medicare so far Kiplinger; by Kathryn Pomroy; 3/17/25 Since President Trump was sworn into office on January 20, he has proposed or initiated changes impacting Medicare. Here's a roundup. ...

Empath Health CEO to Congress: Invest in home-based care Hospice News; by Jim Parker; 3/11/25The federal government must invest further in home-based care, Empath Health CEO Jonathan Fleece told lawmakers at a hearing with the U.S. House of Representatives Ways & Means Health Subcommittee. leece was among several post-acute care leaders who appeared at the hearing, representing home health, hospice, skilled nursing facilities, rehabilitation hospitals and other stakeholders. In opening remarks, Fleece pointed to the benefits of home-based care for patients and families, as well as the sector’s ability to reduce health care costs. 

How Houston Methodist’s ACO reduced its end-of-life spending by nearly 20% MedCity News - Hospitals; by Katie Adams; March 10, 2025 Houston Methodist Coordinate Care is reducing costs through a partnership with Koda Health, a digital platform that guides patients through their end-of-life choices. Preliminary findings show the technology resulted in a 19% reduction in the total cost of care for patients at the end of their life, which equals nearly $9,000 in savings per patient. ... The ACO has been working with Koda Health for more than three years — and it is saving money by getting patients more involved in their end-of-life care plan.

CMS deletes Medicare Advantage vision statement, signaling another shift from health equity Fierce Healthcare - Regulatory; by Noah Tong; 3/10/25 The Centers for Medicare & Medicaid Services (CMS) wiped away the agency’s stated intentions for the future of Medicare Advantage (MA), underlining new uncertainty for the future of health-related social needs, CMS Innovation Center models and the federal health program. ... A frequently asked questions page gave further explanation, as did an executive summary of a report to be released in early 2025. The page included a section with the question, “What is CMS’ vision for the future of the MA program?” as of Feb. 22, archived versions of the web page shows. But that question and answer was quietly deleted, and the page was last modified Feb. 26. It previously described how the VBID model helped health plans address health-related social needs and stressed health equity as an important cornerstone of its mission. ... The CMS did not immediately respond to a request for comment.

How much does end-of-life care generally cost? 50 Plus Finance; by David Leto; 3/3/25 [For the public] ... Knowing how much end-of-life care generally costs can help you manage and prepare your finances appropriately to ease the burden on you and loved ones when the time comes. ... The cost of end-of-life care can vary widely depending on the services required. On average, however, Americans spend between $10,000 and $70,000 on such care, with the majority of expenses often occurring in the last year or month of life. These costs can stem from hospital stays, at-home care, or nursing facility care. Hospice, which focuses on comfort and pain management, typically costs less than intensive medical treatments but still averages several thousand dollars each month, or around $150 a day with insurance. Understanding these figures helps you set realistic financial expectations and prepare for them. ...

House sets up potential Medicaid cuts with budget bill passage Modern Healthcare; by Michael McAliff; 2/25/25 Republicans in the House took the first step Tuesday [2/25] toward steep potential healthcare cuts, passing a budget resolution that aims to trim spending by at least $1.5 trillion while also adding trillions to the debt to fund tax cuts. The House voted 217-215 on nearly party lines to begin what is known as budget reconciliation, passing a budget resolution that instructs committees to come up with cuts or extend tax cuts that largely benefit the wealthy. The bill mandates the House Energy and Commerce Committee, which oversees Medicaid and Medicare, come up with the majority of the savings, and cut $880 billion.

New House resolution would throw out 2025 home health rule McKnights Home Care; by Liza Berger; 2/14/25 Rep. Andrew Clyde (R-GA) on Wednesday introduced a resolution for Congress to disapprove of the 2025 home health payment rule. The resolution was referred to the Committee on Ways and Means in addition to the Committee on Energy and Commerce. Home health providers and advocates have  been pushing for Congress to stop the rule, which gives an aggregate 0.5% bump for home health providers but inflicts a permanent behavioral adjustment of -1.975%. ...  In 2023, the National Association for Home Care & Hospice (now the National Alliance for Care at Home) sued the Department of Health and Human Services to block Medicare rate cuts.