Literature Review

Executive Personnel Changes - 4/4/25 Count

HHS restructures duals, PACE offices amid department overhaul Modern Healthcare; by Bridget Early; 4/3/25 The Health and Human Services Department is reorganizing a handful of key programs for dually eligible enrollees and older adults, including laying off numerous staffers. HHS is shuffling how it manages care coordination for people dually eligible for Medicare and Medicaid under the Medicare-Medicaid Coordination Office and the Program of All-Inclusive Care for the Elderly. PACE, which had been poised for growth, offers home and center-based care mostly to dual-eligible Medicare and Medicaid enrollees who qualify for skilled nursing but can still live in their communities. A spokesperson for HHS said the department has “planned productivity enhancements for the PACE management department.” HHS did not elaborate on what management changes for the PACE program might look like.

Widespread firings start at federal health agencies including many in leadership NPR - All Things Considered; by Rob Stein, Sydney Lupkin, Selena Simmons-Duffin, Joseph Shapiro, Carmel Wroth, and Yuki Noguchi; 4/1/25 The Trump administration began sending notices of termination to thousands of staffers at federal health agencies Tuesday [4/1/25], according to interviews with employees and officials at multiple agencies and e-mails reviewed by NPR. The Department of Health and Human Services last week announced it planned to dismiss 10,000 people. These cuts come on top of around 10,000 people already leaving the agencies under the Trump administration's Fork in the Road offer and early retirement. Termination emails went out Tuesday morning to employees and leadership of agencies within HHS, the Food and Drug Administration, the National Institutes of Health, the Centers for Disease Control and Prevention as well as several smaller agencies. Many of those workers only found out they had been fired when they tried to badge into the building after waiting in line and couldn't get in, NPR learned from multiple sources at HHS who didn't want to share their names for fear of repercussions.

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.

Awards and Recognitions: March 2025

Disparities in end-of-life symptom burden linked to complex interplay among wealth, health, and social supportJAMA Network Open; by Peter A. Boling; 3/25On average, US health care spending in the last year of life alone was $80,000, with 12% ($9,500) being out of pocket and mostly incurred before the final 6 months. This problem worsened in the past decade when the nonspecific diagnosis of failure to thrive was removed as a condition eligible for hospice care and more stringent definitions were applied for dementia, which became the next bubble as the hospice balloon was squeezed. Hospice care is a means of reducing symptom burden, but the Medicare payment model discourages prolonged enrollment during slowly progressing advanced chronic illness and effectively limits funding of social support during hospice care, which is particularly problematic for patients with cognitive and functional impairment and for their friends and families. Considering suffering as a medical condition warranting treatment rather than a social problem requiring support services might help with the evolution of a Medicare policy that might provide a more graduated approach to end-of-life care.

Daughter embraces mom’s hospice journey City Sun Times, Phoenix, AZ; by Lin Sue Flood; 3/25/25 As a nurse, Robin Benton is used to caring for people who are ill. But it’s different when your mother is the one who is sick. Her mom, Charlotte Brewer, a former nurse herself, has multiple myeloma, a rare type of blood cancer. In March 2024, the 80-year-old Valley resident decided to stop curative treatments in favor of comfort care with Hospice of the Valley, where she worked for over 10 years, before retiring in 2007. ... Charlotte’s Hospice of the Valley nurse, Kelly Langston, admires the way the family is living this stage of life with great intention, creating new ways to deepen their love for each other. “They came up with an idea for a hug shirt,” shared Kelly. “Everyone in the family painted their arms then took turns hugging each other — stamping an imprint of encircled arms on the shirts. It’s a way to feel each other’s hugs even when they aren’t together.” [Continue reading ...]

National Alliance’s Scott Levy: Hospices need ‘regulatory relief’ to protect ‘sacred benefit’ Hospice News; by Holly Vossel; 3/21/25 The hospice industry is undergoing a transformative period of rising demand and regulatory changes. Providers of all sizes and types are facing mounting operational challenges and financial strains with limited recourse to voice their collective concerns to legislators. This is according to Scott Levy, chief government affairs officer at National Alliance for Care at Home (the Alliance). Levy stepped into the role earlier this year after holding a similar position at Amedisys. He has been involved in government relations, public policy, advocacy and law for more than 20 years. Levy recently sat down with Hospice News to discuss the array of regulatory and legislative evolutions on the horizon in hospice care delivery.  .[Continue reading ...]

CMS will not resume implementation of Hospice SFP in 2025 Hospice News; by Jim Parker; 3/25/25 A federal court has ordered a stay on litigation intended to block the hospice Special Focus Program (SFP) after the U.S. Centers for Medicare & Medicaid Services (CMS) pledged that it would not resume implementation during 2025. The crux of a lawsuit filed by hospice organizations against the U.S. Department of Health and Human Services (HHS) is the criteria that the agency uses to select hospices for the new Special Focus Program (SFP). [Continue reading ...]

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.

Social Media Watch

Today is the National Vietnam War Veterans Day, honoring 50 years since the war's end U.S. Department of Veterans Affairs - The United States of America Vietnam War Commemoration Join us on 29 March, National Vietnam War Veterans Day, as Americans unite to thank and honor Vietnam veterans and their families for their service and sacrifice. ... The United States of America Vietnam War Commemoration honors all veterans who served on active duty in the U.S. Armed Forces at any time from November 1, 1955 to May 15, 1975, regardless of location, and their families. Editor's note: Several hospice "We Honor Veterans" programs have been using this commemoration to thank their community's Vietnam veterans, especially in light of differences between their returns home from those of WWII veterans. Within your networks of colleagues, friends and families, whom can you informally honor, today?

CMS will not resume implementation of Hospice SFP in 2025 Hospice News; by Jim Parker; 3/25/25 A federal court has ordered a stay on litigation intended to block the hospice Special Focus Program (SFP) after the U.S. Centers for Medicare & Medicaid Services (CMS) pledged that it would not resume implementation during 2025. The crux of a lawsuit filed by hospice organizations against the U.S. Department of Health and Human Services (HHS) is the criteria that the agency uses to select hospices for the new Special Focus Program (SFP). [Continue reading ...]