Literature Review

RCT of PC in EDGeriPal podcast; by Eric Widera, Alex Smith, Corita Grudzen, Fernanda Bellolio, Tammie Quest; 4/10/25Today we focus on an intervention, published in JAMA, that gave emergency clinicians basic palliative care knowledge, training, and skills. We talk with Corita Grudzen and Fernanda Bellolio about their cluster stepped wedge randomized trial of a palliative care intervention directed at emergency clinicians... We are fortunate to have Tammie Quest, emergency and palliative trained and long a leader in this space, to help us unpack and contextualize these findings.

Rural US loses 43% of independent physicians: 5 things to know Becker's Hospital Review; by Kelly Gooch; 4/7/25 The number of independent physicians in U.S. rural areas declined 43% over five years — from 21,956 in January 2019 to 12,467 in January 2024 — according to an Avalere study sponsored by the Physicians Advocacy Institute. ... Five things to know:

National Alliance for Care at Home responds to the FY 2026 Hospice Proposed Rule National Alliance for Care at Home, Alexandira, VA and Washington, DC; Press Release; 4/11/25 The National Alliance for Care at Home (the Alliance) issued the following statement [Fri 4/11] in response to the Centers for Medicare & Medicaid Services (CMS) Fiscal Year (FY) 2026 Hospice Wage Index proposed rule, which proposes payment and regulatory updates under the Medicare hospice benefit. The proposed 2.4% payment update fails to adequately address the mounting financial pressures facing hospices nationwide. With escalating operational costs driven by inflation, workforce shortages, and rising expenses for supplies and services, the proposed payment increase would threaten the ability of hospices to sustainably provide quality end-of-life care. “The proposed payment update for FY 2026 falls short of what is needed to sustain high-quality hospice care,” said Dr. Steve Landers, CEO of the Alliance. “Without meaningful adjustments, hospices across the country will face serious challenges—jeopardizing access to care for terminally ill patients and placing added strain on families already facing the unimaginable. ..."

Social Media Watch 4/11/25

Ahead of National Volunteer Week and in celebration of National Volunteer Month, NPHI CEO urges Americans: “Step forward. Be present. Volunteer with your local hospice.” National Partnership for Healthcare and Hospice Innovation (NPHI), Washington, DC; by Matt Wilkinson; 4/16/25 Ahead of National Volunteer Week next week [April 20-26], and in celebration of National Volunteer Month this April, the National Partnership for Healthcare and Hospice Innovation (NPHI) is shining a light on the often-unsung heroes of hospice: volunteers. These compassionate individuals are central to the mission of NPHI’s member providers nationwide, offering their time, energy, and hearts to patients and families during life’s most tender and vulnerable moments. NPHI member organizations rely on nearly 30,000 volunteers to keep their programs running—almost matching the number of full- and part-time staff employed across its national member network. Nationwide, hundreds of thousands of hospice volunteers contribute millions of hours of service annually. This deep tradition of volunteerism isn’t just symbolic—it’s built into the very structure of hospice care. All Medicare-certified hospices are required to have volunteers actively involved in patient and family support, reflecting the core values of compassion and community care that define the field.Editor's note: Throughout the year, find this and more national observances on our newsletters "Healthcare Observances" tab at the top of our website, https://www.hospicepalliativecaretoday.com/resources/healthcare-observances.

Medical Aid in Dying Annual ReportsA compliation by Hospice & Palliative Care Today; 4/14/25Just released:

Regulatory leaked HHS budget signals $40B in cuts, assumes ACA subsidies expire Fierce Healthcare; by Noah Tong; 4/17/25 Department of Health and Human Services (HHS) reorganization plans appear to have been revealed through a leaked Office of Management and Budget (OMB) document. The 64-page PDF with HHS’ plans were first reported by Inside Medicine and later reported by The Washington Post and other news publications. In an update, Inside Medicine said the entire document was authenticated by The Washington Post. ... While the restructuring was broadly announced, and individual offices have been reportedly axed in recent weeks, the leak provides greater insight into how the reorganization, firings, reductions in force and office eliminations and consolidations will fundamentally alter the agency.

CMS to withdraw federal Medicaid match for workforce, social needs, and infrastructure: What states, health care providers and community organizations need to know The National Law Review; by Margia Corner, Adam Herbst of Sheppard, Mullin, Richter & Hampton LLP; 4/16/25 In a move signaling a major shift in federal priorities, the Centers for Medicare & Medicaid Services (“CMS”) recently announced it will limit federal funding for state Medicaid initiatives that support services beyond direct medical care. ... On April 10, CMS notified states that it will no longer approve new, or renew existing, state proposals for Section 1115(a) Demonstration Project expenditure authority to provide federal matching funds for state expenditures for designated state health programs (“DSHP”) and designated state investment programs (“DSIP”). 

Today is National Healthcare Decisions Day - Make your advance care plans Institute for Healthcare Improvement - The Conversation Project; retrieved from the internet 4/14/25The links and resources [provided in this article] explore a variety of resources to help make, discuss and document future healthcare wishes and decisions in your advance care planning. ... The Conversation Project offers free tools, guidance, and resources to begin talking with those who matter most about your and their wishes.

Closing the gap in end-of life care coverage: The role of nonprofits in policy advocacy Forbes; by James Dismond; 4/14/25... As the demand for end-of-life care grows, so will the gap between the care that patients need and what they receive. ... Workforce shortages, restrictive regulations, outdated reimbursement models and misconceptions around hospice services are keeping millions of Americans from accessing quality hospice and palliative care services. ... These barriers disproportionately affect low-income families, rural communities and communities of color. ... Unlike for-profit entities, we can prioritize community needs over shareholders. We can prioritize patient well-being over profits—or, to say it more directly, we put people over profits. And I’ve seen firsthand how advocacy can drive progress. Nonprofits must engage in:

Ahead of National Healthcare Decisions Day, aging and hospice expert urges Americans to commit to vital advance care and end-of-life conversationsNational Partnership for Healthcare and Hospice Innovation (NPHI) press release; by Tom Koutsoumpas; 4/10/25With National Healthcare Decisions Day next Wednesday, April 16, 2025, the National Partnership for Healthcare and Hospice Innovation (NPHI) is marking the occasion by encouraging Americans to use the day as an opportunity to have conversations with family or loved ones about steps they have—or have not—taken regarding their advance care and end-of-life plans. To help with conversations and prepare individuals to have the most effective discussion with their loved ones about these difficult topics, NPHI is also releasing its Five Point Guide below to show everyday Americans on how to have advance care planning conversations. [Points include:]

Opportunities and barriers to artificial intelligence adoption in palliative/hospice care for underrepresented groups: A technology acceptance model-based review Journal of Hospice & Palliative Nursing; by Tuzhen Xu and Gloria M Rose; 4/2/25 Underrepresented groups (URGs) in the United States, including African Americans, Latino/Hispanic Americans, Asian Pacific Islanders, and Native Americans, face significant barriers to accessing hospice and palliative care. ... Findings suggest that AI has the potential to improve decision-making, enhance timely palliative care referrals, and bridge language and cultural gaps. Artificial intelligence tools were found to improve predictive accuracy, support serious illness communication, and assist in addressing language barriers, thus promoting equitable care for URGs. However, barriers such as limited generalizability, biases in data, and challenges in infrastructure were noted, hindering the full adoption of AI in hospice settings. Artificial intelligence has transformative potential to improve hospice care for URGs by enhancing cultural sensitivity, improving communication, and enabling more timely interventions. However, to fully realize its potential, AI solutions must address data biases, infrastructure limitations, and cultural nuances. Future research should prioritize developing culturally competent AI tools that are transparent, explainable, and scalable to ensure equitable access to hospice and palliative care services for all populations. [Continue reading ...]

Top ten tips palliative care clinicians should know about dysphagia and adult swallowing interventions in serious illnessJournal of Palliative Medicine; Sanora Yonan, Taylor Wilde, Alexa Rogers, Kelly J Trumpatori, Kristie Calix, Christina Barnes, Terri Durkin, Eric Mecusker, Christopher A Jones, Caitlyn M Moore, Laura Chahda, Amanda Stead, Lisa A LaGorio, Paula Leslie; 3/25This article highlights the important role of speech-language pathologists (SLPs) in palliative care (PC), emphasizing their contribution to supporting people with eating, drinking, and swallowing difficulties during serious illnesses and at the end of life. The recommendations underscore the necessity of interdisciplinary collaboration among SLPs and other PC team members, the importance of patient and caregiver education, and the application of patient-centered, comfort-focused approaches to dysphagia intervention. Drawing on current research and expert insights, this article explores the use of SLP services in PC, as well as the challenges in supporting people with eating and drinking difficulties in advanced stages of illness, embedded with practical tips for clinicians.