Literature Review

Here’s what experts expect for hospitals in 2025Healthcare Brew; by Cassie McGrath; (emailed 1/6/25) 12/5/24Two experts talked with Healthcare Brew about possible upcoming trends in leadership development and health equity initiatives, and they’re also eyeing potential changes to federal regulations for drug discount programs as well as Medicare and Medicaid. Here’s what providers are anticipating for 2025, according to industry experts. [Including:]

Current challenges in neurocritical care: A narrative reviewWorld Neurosurgery; Safa Kaleem, William T. Harris II, Stephanie Oh, Judy H. Ch'ang; 1/25Neurocritical care as a field aims to treat patients who are neurologically critically ill due to a variety of pathologies. As a recently developed subspecialty, the field faces challenges, several of which are outlined in this review ... [including confusion around] brain death testing or the diagnosis of brain death itself ... Given these difficult scenarios encountered in the neuro-ICU, conversations with patients’ decision-makers are often done with the assistance of palliative care services ... the most common reasons for palliative care consultation in the neuro-ICU were discussing prognosis, eliciting patient and family values, understanding medical options, and identifying conflict. Collaboration with hospital chaplains and palliative care services can be helpful, but cultural humility also needs to be a priority for neurocritical care providers to be able to navigate difficult conversations.

Top Modern Healthcare stories of 2024 Modern Healthcare; by Mary Ellen Podmolik; 12/31/24 Ups and downs in healthcare kept Modern Healthcare reporters plenty busy in 2024, and 2025 is shaping up as a critical year for the industry, particularly as a new administration takes over in Washington, D.C. Our reporters this year did what Modern Healthcare excels at — bringing readers the news along with the context and analysis our audience needs to stay ahead. Get ready for 2025 by catching up on some hot topics during 2024.

The next health system C-suite obsessionBecker's Hospital Review; by Laura Dyrda; 12/30/24 Health system executives spent the last few years building financial stability after the pandemic and adjusting to workforce shifts. Those areas will remain important in 2025, but a new obsession for C-suite executives is emerging. Or, more accurately, re-emerging. Solving capacity issues and becoming more efficient with patient throughput is a top priority for next year, several CEOs and top health system executives recently told Becker's. Many are operating at or near capacity, especially with workforce challenges persisting, and leadership teams are looking for immediate solutions. ... A recent survey from Vizient shows 52.8% of hospital and health system leaders see patient access, throughput and capacity as top focus areas for 2025. Volumes are still elevated compared to pre-pandemic levels, according to Kaufman Hall's "National Hospital Flash Report," and while growth has slowed this year, leaders are still contending with big capacity issues.

10 headwinds for health systems in 2025Becker's Hospital Review; by Laura Dyrda; 12/23/24Healthcare executives are preparing for 2025, a year likely filled with profound challenges and big opportunities. From workforce shortages to financial pressures, technological advances, and policy uncertainties, 74 health system executives and leaders shared their biggest headwinds heading into next year. The big themes include:

Hospital CEOs: What to expect from CMS next yearBecker's Hospital CFO Report; by Laura Dyrda; 12/13/24Healthcare providers will face more reimbursement challenges next year, S&P Global predicts, especially as demographic shifts increase the number of Medicare beneficiaries in many markets. Factors likely to pressure providers next year include:

25 Hospital closures in 2024 Becker's Hospital CFO Report; by Madeline Ashley; updated 12/27/24, 3:06 pm CT Many hospitals and emergency departments have been forced to close in 2024 due to circumstances like high costs and shifts in care needs. Becker's has reported on 25 hospital and emergency department closures in 2024. [Click on the title's link to view the list.]

U.S. health care spending reaches $4.9 trillion Hospice News; by Jim Parker; 12/20/24 The nation’s total health expenditures rose 7.5% to $4.9 trillion in 2023, a new analysis by the U.S. Centers for Medicare & Medicaid Services (CMS) found. This growth took place at a faster pace in 2023 than prior years. In 2022, health care spending rose at a rate of 4.6%. Total Medicare hospice spending accounted for $25.7 billion last year, according to a separate report from the Medicare Payment Advisory Commission (MedPAC). ... About 21% of U.S. health care spending in 2023 was via Medicare, with private insurance representing a 30% share. Medicaid accounted for 21%, and the remaining 10% were out-of-pocket costs. “Hospital care, physician and clinical services, and nursing care facilities and continuing care retirement communities, which collectively accounted for 33% of all out-of-pocket spending in 2023, were the main contributors to the faster growth in 2023,” CMS indicated.

How UCSF Health is rebuilding an 'instrumental' management layer Becker's Hospital Review; by Kelly Gooch; 12/17/24Middle managers have long played a crucial role in industries across the U.S. However, a November article from global management consulting firm Korn Ferry describes "a disappearing layer of middle management," particularly among professional-service firms that are "delayering" to improve flexibility and responsiveness. ...  [Data] shows that in 2023, middle managers accounted for 31.5% of all layoffs, with an average of 22% between 2018 and 2022. While Mitul Modi, Korn Ferry senior client partner in the firm's global healthcare services practice, said layoffs of managers have occurred at various health systems in 2024, he told Becker's he is not seeing this occur with patient-facing roles. Instead, he has observed an increased emphasis on developing middle managers. ... One example of this is San Francisco-based UCSF Health. ... UCSF Health's efforts center around investing in a management core training program.[Click on the title's link to continue reading.]

Health gap at end of life is now wider in US than any other country Science Alert - Health; by Carly Cassella; 12/16/24 A data-crunching survey covering 183 member nations of the World Health Organization has now confirmed what some scientists feared: while years are being added to most people's lives, healthy life is not being added to most people's year. Researchers at the Mayo Clinic found that people around the world in 2019 were living 9.6 years of life burdened by disability or disease – an increase of 13 percent from 2000. In that same time frame, global life expectancy has increased 6.5 years, and yet health-adjusted life expectancy has only increased 5.4 years. In the US, the gap between lifespan and 'healthspan' is growing particularly wide. Between 2000 and 2019, life expectancy in the US increased from 79.2 to 80.7 years for women, and from 74.1 to 76.3 years for men. When adjusting for healthy years of added life, however, the span only increased by 0.6 years among men. And among women, while health-adjusted life expectancy fluctuated slightly over time, in 2019 it matched the figure seen in 2000. The expanding gap means if an American woman lived to the expected 80.7 years of age, the last 12.4 years of her life would on average be impacted by disease or disability.

Characteristics of patients enrolled in hospice presenting to the emergency department American Journal of Emergency Medicine; by Kayla P Carpenter, Fernanda Bellolio, Cory Ingram, Aaron B Klassen, Sarayna S McGuire, Alisha A Morgan, Aidan F Mullan, Alexander D Ginsburg; 12/9/24, online ahead of print Emergency Departments (EDs) frequently care for patients with life-limiting illnesses, with nearly 1 in 5 patients enrolled in hospice presenting to an ED during their hospice enrollment. This study investigates the reasons patients enrolled in hospice seek care in the ED, the interventions they receive, and their outcomes. ... Patients enrolled in hospice most frequently presented to the ED for trauma [36%; with 15% for pain, 12% for catheter/tube malfunction]. Most received laboratory studies and imaging. Nearly half of patients were admitted to the hospital and short-term mortality was high, particularly for patients enrolled in hospice for needs for ED care? Ie.,

Humana in the headlines: 10 updates Becker's Payer Issues; by Andrew Cass; 12/10/24 From Cigna quashing merger speculation to naming a new CFO, here are 10 updates on Humana that Becker's has reported since Oct. 30: 

University of Michigan Health-Sparrow nurses authorize strike as contract negotiations continue CBS News, Detroit, MI; by Elle Meyers; 12/12/24 Union officials representing the University of Michigan Health-Sparrow nursing staff have been working for months for an improved contract, but leaders say they're not close to a deal. "The hospital so far is not making offers that are going to keep up competitive. It's not going to allow us to make sure we maintain our level of care or quality of care," said Jeff Breslin, a registered nurse and the president of the Professional Employees Council of Sparrow Hospital. The University of Michigan bought Sparrow last April. Bresil says he was hopeful for positive change. "They had promised to come in and build new facilities, improve other facilities that we have, which is great, but you've got to take care of the people as well, and frankly, I'm disappointed that this is the direction things are taking," he said. Breslin said contract negotiations between the nurse's union and the hospital began last August. Their contract expired in October, and they still haven't reached a deal. He says nurses want to see more competitive pay, better staffing levels and an improved health plan.