Literature Review

[KY] Attorney General Russell Coleman files lawsuit against Optum Rx for role in opioid epidemic Northern Kentucky Tribune - Kentucky Center for Public Service Journalism; 12/1/24 The Kentucky Attorney General’s Office has announced its latest lawsuit against a corporation behind the worst man-made epidemic in modern medical history. Attorney General Russell Coleman added Optum Rx and its affiliates to the list of those responsible for the opioid crisis. ... According to the Attorney General’s lawsuit, Optum Rx played a central role in the reckless promotion, dispensing, and oversupply of opioids. ... “Defendants have hidden their conduct through non-transparent business practices and by requiring each entity with whom they conduct business, such as opioid manufacturers, to enter into confidentiality agreements or otherwise keep their agreements confidential,” said the lawsuit. “No state has been harder hit by the drug crisis than Kentucky. Last year alone, nearly 2,000 Kentuckians died of a drug overdose,” Attorney General Coleman said. “These groups pushed a profit-fueled agenda at the expense of Kentucky families, who are left with empty seats at the dinner table. Our Office will continue to hold those behind the drug crisis accountable for their devastating actions.”

Court Orders VitalCaring to place 43% of profits into trust for Encompass Health Hospice News; by Jim Parker; 12/3/24 A federal judge in Delaware has ordered home health and hospice provider VitalCaring Group and its private equity backers to share future profits with Encompass Health (NYSE: EHC). The case has a long circuitous history that dates back to 2022 when Encompass Health spinned off its home health and hospice business as a standalone company, now known as Enhabit Inc. (NYSE: EHAB) brand. At the time, VitalCaring CEO April Anthony was CEO of the Encompass home-based case segment. “Encompass is entitled to one recovery,” a court opinion indicated. “That recovery takes the form of an equitable payment stream of VitalCaring’s future profits to be administered via a constructive trust, certain mitigation damages, and attorneys’ fee.” The court ordered that 43% of VitalCaring’s future profits be placed in trust to benefit Encompass. The remaining 57% would go to VitalCaring’s private equity backers, the Vistria Group and Nautic Partners.

18 questions for CEOs to ask themselves Becker's Hospital Review; by Molly Gamble; 11/25/24 McKinsey senior partners developed a CEO performance questionnaire informed by in-depth interviews with more than 70 successful chief executives across industries. The checklist is meant to assess CEOs' performance in six dimensions: setting direction, aligning the organization, mobilizing through leaders, engaging the board, connecting with stakeholders and managing personal effectiveness. "Sure, CEOs have an abundance of financial, operational, and organizational metrics to look at, but what CEOs should be doing to influence those metrics wasn't exactly clear," the authors noted. The checklist serves as both a self-assessment tool and a framework for gathering honest feedback from board members, executives and trusted advisors. [Click on the title's link for] a condensed list of the questions, with commentary and more explanation of each available in the full article from McKinsey here. [Questions address:] 1. Vision. ... 2. Strategy. ... 3. Resource allocation. ... 4. Culture. ... 5. Organizational Design. ... 6. Talent. ... 7. Team composition. ... 8. Teamwork. ... [More]

All-inclusive elder care for aging at home: This nursing home alternative is on the rise Caring.com; by Dom DiFurio; 11/25/2024 ... PACE centers, or Programs of All-Inclusive Care for the Elderly. As of August 2024, 177 programs across 33 states and the District of Columbia are in operation, allowing aging people to stay within their home communities while still receiving the elevated care they would need as older adults living with disabilities or chronic illnesses. A PACE facility is a kind of "one-stop shop" that offers services like dental care, social services, occupational therapy, prescription medication, and nutritional counseling. ... Caring.com examined data maintained by the National PACE Association to see which states have the most programs available to serve their aging populations and how they can impact the quality of care for adults who want to live independently outside a clinical setting for as long as possible. ... Several states are also undergoing trials, expansion, or establishing new PACE programs for their aging residents. Minnesota and South Dakota are considering starting PACE programs. Nevada is in the process of establishing its own program after using COVID-19 funding to experiment with the system to address the health needs of people ages 55 and older who need nursing facility-level care but can still live safely in their communities. Georgia's governor also signed a bill into law earlier this year creating the state's first PACE.

[CAPC] 2024 Serious Illness ScorecardCenter to Advance Palliative Care press release; 12/4/24America’s readiness to meet the needs of people with serious illness. A state-by-state look at palliative care capacity. How does your state rate? How can I improve my state’s rating? Download the full report.

UnitedHealthcare CEO's slaying adds tragic twist to parent company's tumultuous year CBS News WCCO, Minneapolis, MN; by Beret Leone, Stephen Swanson; 12/5/24 Minnesota-based UnitedHealthcare Group Inc. has faced a firestorm of controversy this year. And as investigators search for a motive in the slaying of Brian Thompson, CEO of its insurance arm, they aren't counting anything out. Between a software attack, protests, lawsuits and layoffs by one of its subsidiaries, Thompson's killing adds a tragic end to a troubled year for the company. [Click on the title's link to continue reading.]

Top News Stories of the Month Nov 2024 - TCN Podcast Teleios Collaborative Network (TCN); podcast by Chris Comeaux with Mark Cohen; 12/4/24 What if the future of Hospice and Palliative Care depends on understanding the intricacies of industry integration and regulation?  Join us for an insightful journey through November's most compelling stories that have captured the attention of Hospice and Palliative Care Today's readership. Our conversation reveals the significant impact of national events, from elections to regulatory changes, on shaping news cycles and industry priorities.  Also, rising workforce demands and political changes, such as immigration restrictions, paint a concerning picture for the future labor pool in Hospice Care. We provide a comprehensive analysis of the month's key themes that may have been missed, like tackling issues from CMS payment cuts to the Justice Department's stance on UnitedHealthcare Group's acquisition of Amedisys. This episode is a must-listen for those seeking a deeper understanding of the critical yet often overlooked issues in Hospice and Palliative Care today, and Mark delivers another excellent masterclass on creating compelling headlines. 

UnitedHealthcare CEO Brian Thompson fatally shot in New York City, reports say USA Today; by Christopher Cann; 12/4/24, updated 11:11 am ET The CEO of UnitedHealthcare, one of the largest insurance providers in the nation, was fatally shot Wednesday morning outside the Hilton hotel in midtown Manhattan, where the company was hosting an investors conference, multiple news outlets reported, citing police sources. Brian Thompson, 50, was shot just before 7 a.m. near the hotel on 54th Street between 6th and 7th Avenues, the New York Post, New York Times and WPIX reported. UnitedHealth did not immediately respond to a request for comment from USA TODAY. A spokesperson for the New York City Police Department who declined to be identified by name told USA TODAY a 50-year-old man was fatally shot outside the hotel, but did provide the victim's name, saying the department was waiting to notify the family. 

[Recommendations] OIG Report finds that the Medicare Program improperly paid acute-care hospitals for outpatient services provided to hospice enrollees JDSupra; by Michelle Huntsman; 12/3/24 On November 12, 2024, OIG published a report concluding that the Medicare program overpaid acute-care hospitals an estimated $190 million over five years for outpatient services provided to hospice enrollees. ... OIG made six recommendations to CMS to prospectively address the issues identified:  

705 hospitals at risk of closure, state by stateBecker's Hospital CFO Report; by Molly Gamble; 11/22/24 More than 700 rural U.S. hospitals are at risk of closure due to financial problems, with more than half of those hospitals at immediate risk of closure. The count comes from the latest analysis from the Center for Healthcare Quality and Payment Reform, which is based on CMS's October 2024 hospital financial information. The center's analysis reveals two distinct levels of vulnerability among rural healthcare facilities: risk of closure and immediate risk of closure. ... The report also analyzes hospitals facing immediate threat of closure meaning financial reserves could offset losses on patient services for two to three years at most. Currently, 364 rural hospitals are at immediate risk of shutting down due to severe financial difficulties. [Click on the title's link for] a state-by-state listing of the number of rural hospitals at risk of closure in the next six to seven years and at immediate risk of closure over the next two to three years. Editor's note: Consider how these closures impact patients' trajectories of serious illness, timely treatment plans, referrals to home health, nursing facilities, and hospice care. How do these impact your service areas? What are the root causes for so many potential closures?

Awards and Recognitions: Nov 2024

Q&A: Prioritizing health equity with Emory Healthcare’s Chief Transformation Office CDW Healthcare - Patient-Centered Care; by Teta Alim; 11/19/24 Most healthcare organizations regularly prioritize goals to improve the patient experience and increase clinician satisfaction, aligning with the Quintuple Aim. Atlanta-based Emory Healthcare created the role of chief transformation officer to focus on these areas, and in July 2023, Dr. Amaka Eneanya became the first to fill the role. ... What would you say were the top three lessons you learned during the first year in your new role? ENEANYA: It's been a great year. For lesson one, as someone coming from a different part of the U.S., ingraining yourself and getting to know the people and the culture of the organization that you’re in, that’s important to determine the change readiness of an organization. ... The second lesson is that change is exciting. There's a lot of trepidation with change, and part of being effective with change management and transformation is really garnering excitement. ... The third lesson that continues to be pervasive in my career is that health equity is poorly understood. ... You have to start with the basic foundation and concepts of health equity before you can make initiatives, otherwise people won't understand what you're doing, and they might have a visceral response to what you're doing because of the misinformation around health equity.