Literature Review

With some fun for Halloween--also known as The Day of the Dead (el Día de los Muertos)--we offer today's "Headlines" to "treat" your day.

Customizing a palliative program to patient, payer priorities Hospice News; by Jim Parker; 10/23/24 While some palliative care programs mirror the hospice model, more operators are working to tailor their services to patients’ specific needs, with varying intensity. This is increasingly important as payment shifts towards value-based payment models in which demonstrating cost savings is crucial to success. Providers need to demonstrate strong performance on quality scores as well as a track record of effectively preventing avoidable hospitalizations, readmissions and emergency department visits. This is particularly the case when negotiating contracts with Medicare Advantage plans, Accountable Care Organizations (ACOs) and other value-based payment arrangements, Sue Lynn Schramm, a partner of the hospice and palliative care consulting company Confidis, LLC, said in a presentation at the National Hospice and Palliative Care Organization Annual Leadership Conference. [Click on the title's link to continue reading.]

Telehealth vs in-person early palliative care for patients with advanced lung cancer-A multisite randomized clinical trialJAMA; Joseph A. Greer, PhD; Jennifer S. Temel, MD; Areej El-Jawahri, MD; Simone Rinaldi, ANP-BC; Mihir Kamdar, MD; Elyse R. Park, PhD, MPH; Nora K. Horick, MS; Kedie Pintro, MS; Dustin J. Rabideau, PhD; Lee Schwamm, MD; Josephine Feliciano, MD; Isaac Chua, MD, MPH; Konstantinos Leventakos, MD, PhD; Stacy M. Fischer, MD; Toby C. Campbell, MD; Michael W. Rabow, MD; Finly Zachariah, MD; Laura C. Hanson, MD; Sara F. Martin, MD; Maria Silveira, MD; Laura Shoemaker, DO; Marie Bakitas, DNSc; Jessica Bauman, MD; Lori Spoozak, MD; Carl Grey, MD; Leslie Blackhall, MD; Kimberly Curseen, MD; Sean O’Mahony, MB, BCh, BAO; Melanie M. Smith, MD; Ramona Rhodes, MD; Amelia Cullinan, MD; Vicki Jackson, MD; for the REACH PC; 9/24The delivery of early palliative care virtually vs in person demonstrated equivalent effects on quality of life in patients with advanced NSCLC [non-small cell lung cancer], underscoring the considerable potential for improving access to this evidence-based care model through telehealth delivery.

Annual wellness visits and early dementia diagnosis among Medicare beneficiariesJAMA Network Open; Huey-Ming Tzeng, PhD; Mukaila A. Raji, MD, MS; Yong Shan, PhD; Peter Cram, MD, MBA; Yong-Fang Kuo, PhD; 10/24Optimal dementia care depends on early recognition of cognitive impairment and timely diagnosis of Alzheimer disease and related dementias (ADRD). Optimal dementia care should reflect what matters most to patients and adhere to evidence-informed ADRD stage-specific health care. These findings indicate that AWV [annual wellness visit] recipients had a timelier first MCI [mild cognitive impairment] diagnosis than those who did not receive an AWV, but first ADRD diagnosis differed little. This study suggests that the Medicare AWV health policy may increase MCI identification, prompting more specialized care.

Martis Capital rumored to purchase Three Oaks Hospice’s in $150m deal Hospice News; by Holly Vossel; 10/18/24 The private equity firm Martis Capital may soon acquire Dallas-based Three Oaks Hospice for a price tag ranging from $150 million to $160 million. Rumors of the potential sale appeared today in an Axios report, in which unnamed sources reportedly confirmed the deal. The Nashville-based investment and management company Petra Capital currently owns Three Oaks Hospice, which reportedly generates between $10 and $13 million in EBITDA, Axios indicated. Rumors that the hospice was considering a potential sale were first reported last month by the website Ion Analytics. The private-equity backed company provides hospice, palliative care and bereavement services across 28 locations in seven states. 

Home health care aide charged with manslaughter in death of elderly central Florida man West Orlando News, Orlando, FL; by Staff; 10/20/24[This article updates the story we posted on 10/1/24, Polk County home health aide accused of sleeping on the job arrested in man’s death: ‘He was old anyway.']... According to the affidavit, Taylor, who was employed by Assisting Hands Home Health Care as a health aide, worked the evening hours at the man’s home in Winter Haven. ...  He was also receiving services from Good Shepherd Hospice beginning on August 14, 2024. ... During an autopsy, it was discovered the patient had an implanted pacemaker. The device manufacturer was later able to conduct a download and provide cardiac data stored on the victim’s implanted pacemaker which confirmed that the victim was still alive at 1:00am when the victim was initially found by Taylor lying on the floor. According to the Medical Examiner, had Taylor called 9-1-1 when she first found the victim, as required by her own company’s policy, the victim would not have died. The Medical Examiner ruled the victim’s cause of death positional asphyxia with a contributory cause of pre-existing health issues. 

Nonprofit endeavors to facilitate food justice Towne Post Network; by Julie Yate; 10/17/24 Bringing Justice Home [in Louisville, KY] is a nonprofit organization committed to alleviating hunger caused by food insecurity for those facing disabilities and chronic or serious illnesses. Now in its fourth year, the completely volunteer-run initiative seeks to facilitate food justice by delivering groceries and household supplies to health-compromised families and individuals who fall below the poverty line. Equally important is the relationship building that occurs as resources are shared and volunteers open their hearts to bringing justice closer to home. ... “Bringing Justice Home is a new kind of neighborhood that goes beyond zip codes, race, disabilities, health labels or status,” says Constance Merritt, who co-founded the organization along with her wife, Maria Accardi. Merritt is a published writer and a licensed social worker with a master’s degree from the University of Louisville. She has worked with older adults in low-income senior housing, patients and families in hospital palliative care, and individuals receiving HIV and AIDS services. 

Who gets to access a “good death"? Adelphi University, New York; by Zainab Toteh Osakew and Jennifer McIntosh; 10/23/24Socioeconomically disadvantaged neighborhoods have fewer home hospice agencies, study shows. ... “We know that poorer neighborhoods have continued to lag behind in utilization of hospice care. For decades, scientists have attributed it to cultural values or preferences about care,” said Zainab Toteh Osakwe ’06, PhD, associate professor in the Adelphi University College of Nursing and Public Health and an expert in home healthcare. ... Dr. Osakwe partnered with a geospatial analyst at the University of North Dakota to uncover patterns in the locations of hospice offices. Drawing on information made publicly available by the Centers for Medicare and Medicaid Services, they culled data related to 3,447 hospice providers and 4,584 Medicare-certified hospices nationwide. Next, they geocoded hospice agency addresses to the social vulnerability index (SVI), a measure developed by the Centers for Disease Control and Prevention that geographically ranks at-risk communities. ... Dr. Osakwe and her team found that hospice agency offices were far more likely to be clustered in neighborhoods with greater socioeconomic advantage. Predominantly Black and Hispanic neighborhoods also contained significantly fewer hospice agency offices. While the results align with prior studies on hospice supply and community-level wealth, theirs is one of the first to investigate hospice agency availability by neighborhood.

In memoriam: Dr. Robert TwycrossIAHPC press release; 10/21/24The International Association for Hospice & Palliative Care (IAHPC) mourns the death of Dr. Robert Twycross, an outstanding pioneer of the global palliative care movement. A lifetime member of the IAHPC, Dr. Twycross made a significant contribution to the IAHPC List of Essential Medicines, developed years before the World Health Organization added a special section for essential medicines for pain relief and palliative care. Dr. Twycross was born on January 29, 1941, and died yesterday, October 22nd, 2024. He was a pioneer of the hospice movement, helping to establish palliative care in the 1970s as an accepted field of modern medicine.

Hospice fraud casts lengthening shadow over future of industryHospice News; by Holly Vossel; 10/11/24Fraudulent operators in the hospice space have misspent millions of Medicare dollars in recent years. This problem has become so severe that it is one of the defining issues facing the hospice industry, with providers and other industry stakeholders expressing concern about significant impacts to future payment, access, sustainability and utilization. This is the first of a two-part Hospice News series that examines the financial and operational pressures weighing on the minds of hospice providers amid instances of fraud, waste and abuse occurring in the industry.Notable mentions: Patrick Harrison, Senator Elizabeth Warren, MedPAC, Lauren Hunt.

Caring for the family caregivers made ill by their work Penn LDI; by Hoag Levins; 10/11/24 A randomized controlled trial (RCT) led by LDI Senior Fellow Barbara Riegel, PhD, RN, of the University of Pennsylvania School of Nursing has identified a virtual health coaching intervention that helped lessen stress for unpaid family caregivers who often neglect their own care. Published in Circulation: Heart Failure, the study focused on unpaid family caregivers providing care to adults with chronic heart failure (HF)—a condition that occurs when the heart can’t pump enough blood for the body’s minimal needs. Because the disease has a variety of symptoms and manifestations that limit palliative care and respite services, it places a heavy burden on home caregivers who are “are commonly overwhelmed and face emotional, psychosocial, and financial risks that result in a decline in their own health and wellness.”Editor's note: Family Support Through Serious Illness is an online video library of 30 brief, state-of-the-art videos for family caregivers, used upstream in the trajectory of serious illness and through palliative/hospice care. These pair with a staff video training, "Empathy for Hospice Professionals."  These are designed and provided by Composing Life Out of Loss, a sponsor for this newsletter.

Fear of cancer recurrence in adult survivors of childhood cancerJAMA Network Open; Alex Pizzo, MSc; Wendy M. Leisenring, ScD; Kayla L. Stratton, MSc; Élisabeth Lamoureux, BA; Jessica S. Flynn, MSc; Kevin Alschuler, PhD; Kevin R. Krull, PhD; Lindsay A. Jibb, PhD, RN; Paul C. Nathan, MD, MSc; Jeffrey E. Olgin, MD; Jennifer N. Stinson, PhD, RN; Gregory T. Armstrong, MD, MSc; Nicole M. Alberts, PhD; 10/24In this cross-sectional study of 229 North American adults who survived childhood cancer, one-third of survivors reported experiencing elevated fear that their primary cancer will recur or a subsequent malignant neoplasm will develop. Fear of cancer recurrence was associated with chronic health conditions, treatment-related factors, anxiety, depression, and perceived health status.