Literature Review

Empassion achieves $34 million in savings in novel Medicare program serving high needs patients Globe Newswire, New York City; 11/21/24 Empassion Health, Inc., the nation’s largest managed care provider of high-quality end-of-life care for adults living with serious illness so that they can have more good days, today reported near-record results for four Medicare Accountable Care Organizations (ACOs) serving Original Medicare lives in 35 states.  Specifically, Empassion achieved total gross savings of $34.1m in the High Needs Population Track of ACO REACH for Performance Year 2023 while managing a record number of lives – nearly 9,000 across 35 states – in total cost-of care arrangements.  This includes a 50-percent reduction of unnecessary hospital stays.  Empassion also earned the highest quality scores for provider communication and care coordination.  “While we are enormously proud of the $34 million in Medicare savings, more important is that Empassion provided high-quality end-of-life care for adults living with serious illness so that they had more good days,” said Robin Heffernan, the CEO of Empassion. “These outcomes are specific to Empassion and its unique model. ..." 

Home health, home care companies gear up for acquisitions in 2025 Modern Healthcare; by Diane Eastabrook; 11/18/24 Acquisitions in the home care industry are poised to take off in 2025, fueled by lower interest rates and President-elect Donald Trump's incoming administration. Large home care providers including Addus HomeCare, Aveanna Healthcare and the Pennant Group said during third quarter earnings calls they would aggressively look for deals next year to gain scale and better compete for hospital referrals. 

LECOM Health opens Erie County's first specialty hospice unit Erie Times-News, Erie, PA; by David Bruce; 11/15/24 Erie County will soon have its first specifically designed medical unit for end-of-life care when LECOM Nursing and Rehabilitation Center opens its Visiting Nurses Association Specialty Hospice Unit later this month. Until now, local hospice patients who require a higher level of medical care than what can be provided at home usually lived their final days at a nursing home or hospital. The reluctance to open a dedicated hospice unit in Erie County is due to operating costs, Lin said. State laws require each unit to have a medical director and registered nurses, and the reimbursement for hospice care makes it difficult to cover those costs if there are fewer than four or five patients at a time. "Since this unit is part of the Nursing and Rehabilitation Center, we can share the medical director and registered nurses," Lin said.

Hazel Dell couple face manslaughter charges in death of relative, 87, in their care The Columbian, Clark County, WA; by Becca Robbins; 11/14/24A Hazel Dell couple are facing charges of manslaughter and criminal mistreatment for the 2022 death of an 87-year-old relative who was under their care. ... In April 2022, state Adult Protective Services referred a report to Clark County sheriff’s detectives about the March 18 death of Marilyn Rogers at a Longview hospice facility. The woman had lived with Joel and Kathryn Rogers, her son and daughter-in-law, at their apartment before her death, according to a probable cause affidavit. ... Emergency room staffers noted Marilyn Rogers had multiple ulcers and pressure wounds that appeared to be infected. She also showed signs of dehydration and malnourishment. Blood work showed she also suffered from sepsis due to infection. ... Doctors recommended Marilyn Rogers be placed in hospice, and once she was, staff said Kathryn and Joel Rogers never visited her. Hospice staff said they struggled to get in touch with the couple for the roughly 10 days Marilyn Rogers resided there, the affidavit states.

Meals on Wheels substantially reduces risk of senior hospitalizations: report McKnights Home Care; by Adam Healy; 11/8/24 Home-delivered nutritious foods programs can help keep seniors out of the hospital and reduce their feelings of social isolation, according to a new report by Meals on Wheels and home care technology firm WellSky. The report examined how Meals on Wheels programs helped seniors recover after being discharged from a hospital stay. Each meal delivery also involved a social determinants of health assessment, which allowed Meals on Wheels staff to engage with participants and gauge their wellness and safety. After 30 days of the program, the researchers observed an 85% decrease in hospitalizations among participants. Approximately 98% of meal recipients said that Meals on Wheels helped their recovery, and 61% said it lowered their feelings of social isolation.Editor's note: While we know hospice patients experience a significant decline in appetite, the person's changing needs for nutrition continue. Pair this data with several recent articles we've posted regarding seniors' struggles compounded by living alone, isolation, and depression. We invite you to explore this educational/support video for caregivers/families of persons experiencing serious illness, palliative, or hospice care: Small Words - Big Meanings: EAT. Disclosure: Composing Life Out of Loss is a sponsor of our newsletter.

‘Everything is lining up’: Home-based care M&A expected to soar in near-term future Home Health News; by Audrie Martin; 11/11/24 Home health, home care and hospice M&A was historically high in 2021, with high valuations serving sellers and solid return on investment serving buyers. Transactions plummeted after that, but recent signs suggest M&A is beginning to pick back up across sectors. ... Sellers should expect questions about employee retention, the company’s track record of growth after M&A and whether their leadership has done due diligence before entering the race. ... Experts predict that large, founder-led home health and hospice businesses will be in high demand in the coming year. Larger home care companies, especially those that are Medicaid-funded, will also be in demand. 

Homecare owner allegedly withholds $86k in wages HomeCare, Indianapolis, IN; 11/11/24 The U.S. Department of Labor (DOL) has alleged that home health care company owner Hahn March violated federal wage laws and withheld $86,000 in wages by using improper pay practices at her two Indianapolis, Indiana, companies: Signal Health Group Inc. and SHG Employee Leasing Company. In 2018, federal investigators cited March for not paying overtime wages to employees at her then-owned company, Aging and Disabled Home Healthcare. ... The complaint was filed following an investigation by the DOL Wage and Hour Division, which discovered March and Nancy Stanley, the chief financial officer of both companies, used an artificial regular rate pay scheme to lower hourly pay rates and, in turn, shortchanged employees $86,427 in overtime wages. ... The DOL is seeking $172,854—including $86,427 in back wages and an equal amount in liquated damages—for 43 current and former employees. ... “Employees who work in home health care—one of our nation’s lowest-paying professions—provide necessary daily and hospice care that allow individuals to remain in their homes and aid them in navigating their basic needs, providing dignity and comfort to clients and their families,” said Aaron Loomis, Wage and Hour Division district director.

Veterans and Alzheimer's: 6 lifestyle tips for staving off the disease NOLA.com, New Orleans, Louisiana; by Dana Territo; 11/11/24 Are veterans more prone to Alzheimer’s disease? According to the U.S. Department of Veterans Affairs, veterans are more likely to develop Alzheimer's disease and other dementias than the general public, and the number of veterans with Alzheimer's is expected to grow. For instance, in 2021, an estimated 457,391 veterans had Alzheimer’s disease, and that number is projected to increase by 8.4% to more than 488,000 by 2033. Age is the biggest risk factor for Alzheimer’s disease as a whole, and veterans are more likely to have health conditions that further increase that risk, including high cholesterol, traumatic brain injury, post-traumatic stress disorder and depression. Additionally, homelessness contributes to that risk as homeless veterans are more likely to have an Alzheimer’s diagnosis than those who are stably housed.

Sioux City’s first Caregiver Olympics celebrates home care KCAU Sioux City; by Alyssa Tatsch; 11/7/24 November is National Care at Home Month, and to celebrate, several local healthcare organizations came together to participate in Sioux City’s first Caregiver Olympics. “I was watching the Olympics this summer and I was thinking of something fun to do with our caregiving team,” Visiting Angels owner and director Kristen Hammerstrom said. “Then I was at a meeting with some of the other [home care organizations] and I floated the idea to them and they said ‘that would be awesome.’” In honor of National Hospice and Palliative Care month, nine Sioux City caregiving teams went head-to-head competing in a relay race with specialized in-home care tasks. ... “As much as it is difficult to be a caregiver, it is also difficult for these employees too to help and take care of families, so this is just our light heartfelt fun moment to help people,” Hospice of Siouxland marketing & fund director Kim Wilson said. Despite the friendly competitive atmosphere, all nine teams shared one common goal. “While we might be competitors, at the end of the day our main goal is to care for patients and make sure that our patients and their loved ones are taken care of. That is our main goal,” Wilson said.

“I’m 68 and totally alone”: 50 people share what it’s like being seniors AOL.com - Bored Panda; by Dominyka; 11/9/24 People are different in their upbringing, in their tastes, even in their looks. But all people do have one thing in common: we're all heading towards the same end. With the exception of Bryan Johnson, maybe. Still, we're all aging, whether we like it or not. And with aging comes social isolation; according to a 2024 Medicare report, 57% of adults aged 65 and older report feeling lonely. The users of Quora recently tackled this problem when one person wrote: "I'm 63 years old and so lonely. Does it matter to anyone?" Many older people rushed to the comments to share their stories, highlighting the sad realities they face today. Bored Panda sought the expertise of the anti-ageism activist Jacynth Bassett, Founder and CEO of Ageism Is Never In Style about how important social connections are to us as we age. We also spoke with her about the right terminology when referring to older people and how we can all spot ageist attitudes in ourselves. 

Most heart failure patients miss out on guideline-recommended palliative care Cardiovascular Business; by Dave Fornell; 11/6/24 Over the past decade, the American Heart Association (AHA) and European Society of Cardiology have recommended integrating palliative care into heart failure management. Despite these recommendations, the use of palliative care for heart failure remains low in the United States. Racial and geographic variations in access and use of palliative care are also pronounced, highlighting health disparities. These were the findings of a recent study in the Journal of the American Heart Association. Researchers at Saint Louis University led the study and said only one in eight patients with heart failure in the United States receive palliative care consultations within five years of diagnosis. Their study highlights the alarmingly low uptake of palliative care among adults with heart failure in the U.S., especially compared to patients with cancers that have the same mortality rates. The study also pointed out significant racial and geographic disparities. Black patients were 15% less likely to receive palliative care compared to their white counterparts. They said this disparity is particularly concerning given the higher cardiovascular risk and mortality rates in the Black population.

Elevance is latest to invest in home health with Carebridge acquisition HealthLeaders; by Jay Asser; 11/4/24 The home-based care business is seeing increased interest and could be ripe for more activity going forward. Key Takeaways: 

Calendar Year (CY) 2025 Home Health Prospective Payment System Final Rule Fact Sheet (CMS-1803-F) CMS Newsroom; Final Rule Fact Sheet (CMS-1803-F); 11/1/24On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the Calendar Year (CY) 2025 Home Health Prospective Payment System (HH PPS) final rule, which updates Medicare payment policies and rates for Home Health Agencies (HHAs). This rule also updates the intravenous immune globulin (IVIG) items and services’ payment rate for CY 2025 for Durable Medical Equipment (DME) suppliers. As described further below, CMS estimates that Medicare payments to HHAs in CY 2025 would increase in the aggregate by 0.5%, or $85 million, compared to CY 2024. [Click on the title's link for more information.]