Literature Review

Grief care efforts should include settings outside of hospice, provider group say McKnights Senior Living; by Kimberly Bonvissuto; 7/3/24 If standards are developed for high-quality bereavement and grief care, they must apply to settings outside of traditional hospice care, such as affordable senior housing, where there is a “critical lack” of mental health services. That’s according to LeadingAge, which submitted comments last week to the Agency for Healthcare Research and Quality on a draft report from a research project that will inform an independent panel that will develop standards for high-quality bereavement and grief care. Katy Barnett, LeadingAge director of home care and hospice operations and policy, highlighted the need for cross-continuum grief and bereavement assessments, interventions and resources, including in settings outside of traditional hospice care, such as affordable senior housing.

HHS to impose penalties on providers that block patients’ health information McKnights Home Care; by Adam Healy; 6/24/24In a bid to promote easier access and exchange of patients’ health records, the Department of Health and Human Services published a final rule Monday outlining penalties for providers that block access to electronic health information. ... Fragmented and inaccessible patient data can prevent long-term and post-acute care providers from seeing the full picture of a patients’ health. Hospitals, for example, are not required to share updates about a patient’s health with the patient’s post-acute care provider. As a result, home health and home care agencies frequently cannot access patients’ electronic health records to help assess and treat patients. Three disincentives: ... First, hospitals that commit information blocking can be subject to a reduction of three quarters of an annual market basket update. Second, clinicians eligible for the Merit-based Incentive Payment System will receive a zero score in the “promoting interoperability performance” MIPS category, which can be equivalent to roughly a quarter of the clinician’s MIPS score in a given year. Lastly, providers that participate in information blocking can have their Medicare Shared Savings Program or Accountable Care Organization eligibility revoked for at least one year. ...Editor's Note: Almost any solution raises additional challenges. How does HIPAA interface with this? How might a cyberattack at a hospital (or other healthcare agency) affect the patients' other agencies, putting them at risk as well?

48 health systems with strong finances Becker's Hospital CFO Report; by Andrew Cass; 6/20/24 Here are 48 health systems with strong operational metrics and solid financial positions, according to reports from credit rating agencies Fitch Ratings and Moody's Investors Service released in 2024. Note: This is not an exhaustive list. Health systems were compiled from credit rating reports. [Click on the title's link for the list.] Editor's Note: This list is from larger "health systems," and does not reflect stand-alone hospice and palliative organizations.

Acting now to sustain and improve America’s healthcare system: Advice from innovative physicians and health system leadersSheppardMullin Healthcare Law Blog; by Kathleen O'Neill, John Golembesky, Jeralin Cardoso, Chi Huynh & Carolyn Young; 6/6/24 At [the recent] America’s Physician Groups Spring conference in San Diego, California, we listened as physicians and health system leaders described the ways in which they are responding to short and long term challenges to the sustainability of America’s healthcare system in its current form. It now stands at a critical juncture, facing challenges such as provider shortages and burnout, increasing concerns around access and cost for pharmaceutical products and other supplies, the increasing burden of managing chronic diseases, rising demand for services across the spectrum from an aging population, and balancing the transition to value-based care models in a predominantly fee-for-service environment. ... Here, we outline the key areas of focus described by leaders at the conference: ... 

Transformative peer connections: Early experiences from the ASCO Palliative Care Community of Practice American Society of Clinical Oncology; by Mazie Tsang, Cristiane Bergerot, Natasha Dhawan, Rushil Patel, Darcy Burbage, Tingting Zhang, Jafar Al-Mondhiry, Joseph McCollom, Ramy Sedhom; 5/22/24 online ahead of print in June 2024  ... there are barriers to implementing palliative oncology at many institutions for myriad reasons. ... In this article, we discuss an innovative strategy that ASCO implemented called the Communities of Practice (CoP). We share our experiences as the Palliative Care CoP and how our group seeks to develop processes and structures to collectively promote systemic change and enhance palliative care delivery for people with cancer. Our Palliative Care CoP engages with senior leaders, administrators, and those in power to achieve a shared vision of delivering holistic health care for people with serious illness. ... [We address] eight main domains:

Hospital-at-home grows despite regulatory uncertaintyModern Healthcare; by Diane Eastabrook; 5/17/24Health systems and technology companies are betting big on home-based hospital care, despite regulatory uncertainty about the program’s future. Hospitals are bullish on at-home acute care because it can save money and make more beds available in their facilities for sicker patients. Medicare also pays health systems the same rate as it would for an inpatient admission. Since January, two health systems and 16 hospitals launched hospital-at-home programs under the Centers for Medicare and Medicaid Services’ Acute Hospital Care at Home waiver, bringing the total number of programs to 336 across 37 states, according to the agency’s website. More programs are slated to launch this year as Congress considers whether to extend the waiver beyond its Dec. 31 expiration date. Hospital-at-home allows certain patients to receive acute-level care where they live through telehealth and in-person visits, supplemented with remote patient monitoring. The concept gained traction during the COVID-19 pandemic when CMS approved a waiver in 2020 to alleviate overcrowding in hospitals. Large health systems, including Mass General Brigham, Geisinger and the Cleveland Clinic have invested heavily in home-based acute care. Many smaller hospital systems are doing the same by leveraging in-home care technology.

Hospital CEOs ask patients to receive care at home Becker's Hospital Review; by Madeline Ashley; 5/14/24 Hospital executives are making the push to move more care, specifically recovery rooms and exams, out of the hospital and into patient homes, to potentially save money and improve finances as the country continues to move out of the pandemic, Politico reported May 11. And Congress is supporting these efforts by introducing legislation that would expand at-home care and to allow Medicare to continue funding telehealth. Here are five findings from the report: ... [Click on the title's link to read more.]

House Committee vote gives hope to extending telehealth, hospital at home waivers Health Leaders; by Eric Wicklund; 5/9/24 The House Ways and Means Committee has voted to advance the Preserving Telehealth, Hospital and Ambulance Access Act (HR 8261), which would, among other things,  continue pandemic-era Medicare waivers enacted by the Centers for Medicare and Medicaid Services (CMS) for telehealth access and coverage through 2026 and extend the CMS Acute Hospital Care at Home waiver for an additional five years, to the end of 2029.

Palliative patients can die peacefully at home with paramedic support, claims proposed frameworkRiotack - Australia; by James Day; 5/6/24A proposed national framework suggests paramedics could help ease pressure on emergency departments by supporting palliative care patients who wish to die at home. Published in the leading international peer reviewed journal Palliative Medicine, the framework seeks to embed palliative care into paramedics’ core business and reduce needless transports to hospital. ... Lead author and trained paramedic Dr. Madeleine Juhrmann developed the framework in consultation with paramedics, palliative care doctors, GPs, carers with lived experience and others. The expert group – representing six countries and all the states of Australia – agreed on the framework’s 32 service changes to standardise best practice for paramedics delivering palliative care in community-based settings.Pair this with a USA article in today's newsletter, "Stranded in the ER, seniors await hospital care and suffer avoidable harm." 

Big Bend Hospice, Tallahassee Memorial HealthCare Partner on transformative approach to transitional careBusiness Wire; 5/2/24 Big Bend Hospice (BBH) and Tallahassee Memorial HealthCare (TMH) announced a partnership today to improve patient navigation within the healthcare system. This collaboration aims to streamline transitions between hospitals, doctor's offices, rehabilitation centers, and home care. The signing of the Affiliation Agreement creates a governance structure that will develop a transformative approach to improving transitions of care in the Big Bend community. Transitions of care involve a patient's movement between healthcare settings, such as doctor's offices, hospitals, rehabilitation centers, long-term care, home health, hospice, etc. This partnership establishes a network of connected healthcare services, creating a seamless patient journey regardless of specific needs.

Novant Health launches 'hospital at home' with $2.7M donation Becker's Health IT; by Giles Bruce; 4/24/24 Winston-Salem, N.C.-based Novant Health launched a hospital-at-home program thanks to a $2.7 million donation. The health system rolled out the program in March at its coastal North Carolina region, and said the ideal patient is one likely to need four days or fewer of inpatient care. ... atients, who are monitored by technology around the clock, have 24/7 access to a remotely located registered nurse, receive at least two visits a day from paramedics, and meet virtually with a physician once daily. ... The New Hanover Regional Medical Center Foundation provided $2.7 million to help with operational startup costs. Novant Health received a waiver from CMS for the program in 2021.

Valley Health and Blue Ridge Hospice collaborate to offer hospice in the hospital program at Shenandoah Memorial Hospital in Woodstock, VA Valley Health Press Release; 4/15/24 Valley Health and Blue Ridge Hospice have expanded their collaborative Hospice in the Hospital program to Shenandoah Memorial Hospital in Woodstock, VA. On April 1, the two signed an agreement for Blue Ridge Hospice to work alongside the hospital’s care team to provide supplemental comfort care services to ensure eligible patients and families receive the most complete and comprehensive care during and after their stay at the hospital.

[Maine] Senate backs safe staffing bill with aim to increase patient safety, decrease nurse burnout Main Morning Star, by Lauren McCauley; 3/27/24 If passed, Maine would be the second state in the country to institute nurse-to-patient ratios. ... Sen. Stacy Brenner (D-Cumberland), who sponsored the bill, shared with the chamber her experience as a nurse and how the stress of being understaffed can contribute to burnout and what she described as “moral distress.” ... Brenner said the bill accomplishes two goals: increasing patient safety and increasing nurse retention.