Literature Review

Do automated reminders decrease no-show visits in an outpatient palliative medicine clinic? Sage Journals - American Journal of Hospice and Palliative Medicine; by Ruth L. Lagman, MD, MPH, MBA, Renato V. Samala, MD, MHPE, Ahed Makhoul, MD, Kyle Neale, DO, Chirag Patel, MD, Elizabeth Weinstein, MD, Wei Wei, MS, and Xiaoying Chen, MS; 3/23/25 Individuals who do not show up for medical appointments can lead to unfavorable outcomes for both patients and health systems. Automated methods are available to confirm appointments in addition to patient service coordinator (PSC) telephone calls. This study aims to determine the no-show rates for automated methods of confirmation, in-person and virtual visits, and patients living in underserved areas.Conclusion: PSC telephone calls, individuals living within COZ and virtual visits had higher no-show rates.

Rural US loses 43% of independent physicians: 5 things to know Becker's Hospital Review; by Kelly Gooch; 4/7/25 The number of independent physicians in U.S. rural areas declined 43% over five years — from 21,956 in January 2019 to 12,467 in January 2024 — according to an Avalere study sponsored by the Physicians Advocacy Institute. ... Five things to know:

Northern Light Palliative Care helps patients live their best lives The Piscataquis Observer - The Voice of Rural Maine; by Stuart Maine; 3/13/25 People who have received a chronic, life-altering or life-limiting diagnosis can live their best life with the help of Northern Light Palliative Care, and there have been recent changes in the delivery of palliative care.  ... Northern Light Health Palliative Care Service Line Medical Director Dr. Vanessa Little, DO, FAAHPM [described,] ... “We’ve had nurse practitioners who visited people in the home exclusively and now we’re moving to expand the program to a clinic setting and the in-home model is going to be changing a bit." ... Patients can still receive home care “but we’re trying to have palliative care be available to more people,” she said. “We are going to be relying on technology to get the providers, nurse practitioners, and physicians in homes via technology and then have people in person through Northern Light Homecare & Hospice with nursing, critical therapy, and occupational therapy just as we always have.”

VA in IM marks 75th anniversary as a mainstay for veterans’ care The Daily News, Iron Mountain, MI; by Betsy Bloom; 3/6/25 A winter storm didn’t stop the Oscar G. Johnson VA Medical Center from celebrating its 75th anniversary with an open house Wednesday. The facility opened on March 5, 1950 — it then was the largest construction project done in the Upper Peninsula — as strictly an inpatient hospital with 264 beds, primarily for treating World War II veterans ... [and much has] changed in 75 years. The medical center now serves about 22,000 veterans in the U.P.’s 15 counties, along with nine Wisconsin counties — more than 26,000 square miles, giving it the most rural patient base in the VA system. ...  Its hospice area now has a semi-private patio that allows even a full bed to be taken outside so those in end-of-life care can still enjoy some fresh air, said Mary Oman, [a] tour guide.Editor's note: Congratulations and thank you to the Oscar G. Johnson VA Medical Center for your history of innovating care for veterans--especially your rural care system and hospice care. 

WVU nursing faculty aim to enhance rural home care for chronically ill through NIH award WVU Today - West Virginia University, Morgantown, WC; Press Release; 2/26/25 Three West Virginia University nursing faculty know firsthand the difficulties faced by family caregivers and their chronically ill loved ones. With a $2.7 million award from the National Institutes of Health’s National Institute of Nursing Research that is one of the largest ever for the WVU School of Nursing, the faculty researchers aim to support these families while increasing access to care in the rural reaches of the Mountain State by testing an integrated, nurse-led intervention for family home care management of end-stage heart failure and palliative care. ... Through their lived experiences, as well as their previous studies using nursing science to develop and test nurse-led interventions, the three said they hope to improve family caregivers’ and their loved ones’ overall health and well-being, including reducing depression and anxiety, and monitoring and managing end-of-life symptoms.

After 'code issue,' veterans no longer receive free care at UP hospice site MyUpNow.com, Houghton, MI; by Thomas Fournier; 2/5/25 For a veteran staying at hospice care facility, it's important family can visit, especially in rural areas. But what happens when their facility no longer qualifies as a hospice facility for the Veteran's Health Administration (VHA)? Omega House Executive Director Mike Lutz said he received a call from the local Veteran's Affairs (VA) office in Iron Mountain late December 2024 informing him that they would "no longer be servicing veterans at Omega House." ... Veterans who would usually receive a reimbursement through the VA for their hospice care would no longer be able to find that at Omega House, leaving them to get their care 100 miles away or more. 

Stillwater Hospice CFO: A winning recipe for improving rural hospice care Hospice News; by Holly Vossel; 1/23/25 Montana-headquartered Stillwater Hospice has found a successful rhythm to strategic rural-based growth and sustainability. The strategy hinges on building culture, staffing resources and a reputation for quality, according to CFO and Co-founder Chris Graham. Launched in 2017, the hospice company serves predominantly rural-based populations in Montana, northern Wyoming and South Dakota. ... What are the most significant concerns among rural-based hospice providers currently? How have the challenges of rural care delivery evolved in recent years? "Staffing is very hard. You’ve got to find staff who are willing and like to travel because they have a lot of windshield time. It’s also the logistics of remote care. We have patients that live 75 miles or more outside of a town, then once you get there it’s another 20 miles on a dirt road that could be covered in snow and ice. ..." [Click on the title's link to continue reading.]

Allevant Solutions shares over 10 years of insights into rural post-acute care patient outcomes PR Newswire, Mechanicsburg, PA; by Allevant Solutions, LLC; 1/13/25 Allevant Solutions, LLC shared key insights from its experience over a 10-year period showing that partnerships between larger acute care hospitals and rural critical access hospitals (CAHs) for post-acute care benefit patients, health care teams and hospitals. The aggregate, de-identified data reflects patient outcomes from over 100 CAHs across 24 states, specifically around the utilization of the swing bed concept – which Allevant calls Transitional Care.  A swing bed is the federal government's term for a patient bed in a small, rural critical access hospital that can be used for acute or post-acute care after a hospital stay.  Rural patients who have to leave their community for higher levels of care often have difficulty finding high-quality, continuing care when they are ready to return. 

As drugstores close, more people are left in ‘pharmacy deserts’ The San Diego Union-Tribune; by The New York Times Service Syndicate; 12/31/24 In July, a notice appeared on the front door of The Drug Store, the only pharmacy in rural Kernville, in Kern County. After 45 years, the proprietor wrote regretfully, it would be closing in four days and transferring customers’ prescriptions to a Rite Aid about 12 miles away. ... Its closing created practical concerns. “We are an aging population,” Gordon, 69, said of the townspeople. ... Now, those services require a 20- to 30-minute drive to the Rite Aid, which is in Lake Isabella and which Gordon described as understaffed for its growing number of customers. “On any given day, there’s a line of 10 to 15 people waiting at the pickup window,” she said. Unlike The Drug Store, the Rite Aid doesn’t deliver. That leaves Kernville residents in what researchers call a pharmacy desert, defined as living more than 10 miles from the nearest pharmacy in rural areas, 2 miles away in suburban communities or 1 mile away in urban neighborhoods. Nearly 30% of pharmacies in the United States closed between 2010 and 2021, according to a new study in the journal Health Affairs. 

Michigan Center for Rural Health announces new program focused on improving rural based palliative care PRLOG - Press Release Distribution, East Lansing, MI; by Michigan Center for Rural Health - Amanda St. Martin; 12/16/24 The Michigan Center for Rural Health (MCRH) has announced Phase Two of its palliative care programming. Palliative care provides relief from symptoms, pain, and stress associated with serious illnesses and can be administered alongside curative treatments. It is suitable for patients of any age or illness stage. The program titled "Cultivating Comfort: Enhancing Palliative Care in Rural Michigan," funded by the Michigan Health Endowment Fund, will launch on January 1, 2025, and continue through December 2026. ...  Rural adults tend to experience a higher prevalence of chronic conditions compared to their urban counterparts, as they are often older, poorer, and more likely to have multiple chronic illnesses. MCRH's new program seeks to address this need through a community driven approach.

Hospice of Northeast Missouri marks 30 years, eyes future growth KBUR, Burlington, MO; by collinleddy; 11/25/24 Hospice of Northeast Missouri recently marked 30 years of service, expanding from its original focus in Adair County to cover a ten-county region. This growth addresses the critical need for end-of-life care in rural areas, providing support for patients and their families in managing symptoms and caregiving responsibilities. The organization has seen an increase in demand for its services, particularly among Medicare recipients in rural areas. Between 2010 and 2022, the percentage of rural Medicare beneficiaries using hospice care rose from 34% to 42%, reflecting broader trends in aging populations and the growing importance of caregiving. ... As the hospice looks ahead, it plans to further expand its resources and focus on community education, ensuring that more families are aware of the benefits hospice care provides during difficult times.Editor's note: Per the ongoing number of hospices that celebrate decade-marker anniversaries, we typically do not post those articles. However, the growth patterns in these descriptions reflect hospice organizational trends nationwide: expanding geographical access, rural utilization, increased priorities for caregivers, snf the importance of community education.

CMS Innovation Center reimagines rural health care approaches Center for Medicare and Medicaid Innovation; 11/12/24 Re-Imagining Rural Health: Themes, Concepts, and Next steps from the CMS Innovation Center "Hackathon" Series. ... Over sixty million Americans currently live in areas identified as rural, Tribal, frontier, and geographically isolated areas, including the U.S. Territories. Compared to people living in urban areas, rural Americans are more likely to experience poverty, be older, be uninsured, and have a disability. At the same time, rural communities face unique barriers to accessing care due to more limited availability of health care providers, including primary care, specialty care and home and community-based services, and residents often have to travel long distances to obtain health care. [Click on the title's link to continue reading (and distribute) this important 20 page whitepaper.]

Local hospice care offers services The Tribune, Seymour, IN; by Chey Smith; 11/1/24 St. Croix Hospice has recently expanded its reach locally to those in the community who need the resources they provide, ... The firm provides hospice care throughout the Midwest including three other branches in Indiana — Jeffersonville, Newburgh and Indianapolis. While in Seymour, they are able to serve Jackson County as well as those residents from Bartholomew, Brown, Jennings, Lawrence, Monroe, Scott and Washington counties. Caregivers at each hospice location live in the communities they serve, allowing in-person care for patients whenever they need it. Services are available nights, weekends and holidays. Chris Thomas, regional director of clinical operations at St. Croix’s Indiana locations, talked about the importance of this closeness and flexibility. “We wanted to move to this location because we wanted to service the local community,” Thomas said. “Try to stay closer to the community for faster response time.” This phase of someone’s life can be scary, but Thomas says that it doesn’t have to be that way. “People are scared when they hear the word hospice. We just want to let the community know that it’s okay. It doesn’t mean you’re giving up,” he said. “We really want to focus on the time they have left.”