Literature Review

Reps. Van Duyne, Panetta introduce bill to reform hospice Special Focus Program Hospice News; by Jim Parker; 11/6/24 Reps. Beth Van Duyne (R-Texas) and Jimmy Panetta (D-California) have introduced a bill that would reform aspects of the hospice Special Focus Program (SFP). If enacted, the Enhancing Hospice Oversight and Transparency Act also would increase the penalty for hospices that do not report quality measure data to 10% by 2027, up from 4% currently. The SFP has the authority to impose enforcement remedies against hospices with poor performance based on its algorithm. Hospices flagged by the SFP also will be surveyed every six months rather than the current three-year cycle and could face monetary penalties or expulsion from the Medicare program. 

The Pennant Group to seek more hospice, home health deals in 2025 Hospice News; by Jim Parker; 11/7/24 The Pennant Group (Nasdaq: PNTG) has a “robust pipeline” of potential acquisitions in the wings for 2025 across its home health and hospice and senior living business segments. For prospective deals, Pennant scouts for agencies that show strong promise for organic growth that have “talented” local leaders or entrepreneurs in place, according to CEO Brent Guerisoli. Pennant then leverages the resources in its platform to foster growth. “Developing local leaders remains at the heart of our operating model,” Guerisoli said in a Q3 earnings call. “As the talent and experience operations and clusters deepens with strong portfolio companies, our efforts throughout our footprint, we are able to more quickly improve new acquisitions and grow seasoned operations, thus the significant investment we have made in our leadership and development programs is the catalyst for enduring momentum.” Pennant is the holding company for a cluster of independent hospice, home health and senior living providers located across 13 states. Year to date, the company has added more than 60 CEOs to its portfolio agencies as well as 40 internal clinical leaders.

Hopeful for the hospice house Gillette News Record; by Jonathan Gallardo; 11/2/24 Last week, Campbell County Health and the Northeast Wyoming Community Health Foundation announced that they were working together to look at bringing back inpatient services to the Close to Home Hospice House. For many, I’m sure the announcement came as a surprise. The split between the two sides was so public and was drawn out over a couple of years. Bridges had seemingly been burned, never to be crossed again. But wouldn’t you know it, those bridges appear to be on the mend. In their announcements, CCH and the foundation both said they’ve been in talks about what it would take to reopen Close to Home. “Our primary focus is the well-being of our community, and we are committed to transparency as we engage in these preliminary discussions,” CCH said in a press release. 

Longer hospice stays among dementia patients save Medicare dollars Hospice News; by Holly Vossel; 11/4/24 Hospice utilization has tripled among patients diagnosed with Alzheimer’s disease and related dementias (ADRD) during the past two decades. The trend has ignited concerns about these patients’ lengths of stay, as well as praise for hospices’ cost-savings potential. Massachusetts Institute of Technology (MIT) researchers analyzed Medicare fee-for-service claims spanning between 1999 and 2019, including data on hospice billing, patient enrollment, hospitalizations, health costs and chronic condition indicators. Roughly 14.7% of ADRD patients utilized hospices services in 2019, nearly triple the 4.4% of patients who received this care in 1999, according to the research, which was published in the National Bureau of Economic Research. The research compared billing claims among nonprofit and for-profit providers to explore spending associated with longer hospice stays among dementia patients. ...

See photos from Ohio's Hospice facility in New PhiladelphiaTimesReporter; by Andrew Dolph; 10/31/2024[The Ohio Hospice Truman House was renamed the Dr. Leslie Harrod Campus.]

Top 10 Governance, Risk & Compliance (GRC) tool eSecurity Planet; by Claire dela Luna; 10/28/24 In today’s global economy, even small businesses operate across multiple regions and markets, each with its own regulatory landscape. Without effective GRC tools, organizations can quickly fall out of compliance, exposing themselves to security risks and operational disruptions. GRC software solutions enable businesses to manage these risks by automating policies, tracking controls, and providing real-time compliance monitoring across international borders. .. Here’s a guide to help you make the best choice.

Study: Hospice care provides major Medicare savings Medical Xpress; by Peter Dizikes, Massachusetts Institute of Technology; 10/24/24 Hospice care aims to provide a health care alternative for people nearing the end of life, by sparing them unwanted medical procedures and focusing on the patient's comfort. A new study co-authored by MIT scholars shows hospice also has a clear fiscal benefit: It generates substantial savings for the U.S. Medicare system. ... In recent decades, hospice care has grown substantially. That growth has been accompanied by concerns that for-profit hospice organizations, in particular, might be overly aggressive in pursuing patients. There have also been instances of fraud by organizations in the field. Yet, the study shows that the overall dynamics of hospice are the intended ones: People are indeed receiving palliative-type care, based around comfort rather than elaborate medical procedures, at less cost.Editor's note: This study limited its data to for profit hospice agencies. That said, its results cannot be miscontrued to provide any type of comparison between for profits and non profits, in that data from non profits was (apparently) not examined.

CIOs must prepare their organizations today for quantum-safe cryptography IBM; by Mark Hughes, Joachim Schäfer and Arfan Sabar; 10/24/24Quantum computers are emerging from the pure research phase and becoming useful tools. They are used across industries and organizations to explore the frontiers of challenges in healthcare and life sciences, high energy physics, materials development, optimization and sustainability. However, as quantum computers scale, they will also be able to solve certain hard mathematical problems on which today’s public key cryptography relies. A future cryptographically relevant quantum computer (CRQC) might break globally used asymmetric cryptography algorithms that currently help ensure the confidentiality and integrity of data and the authenticity of systems access.The risks imposed by a CRQC are far-reaching: possible data breaches, digital infrastructure disruptions and even widescale global manipulation. These future quantum computers will be among the biggest risks to the digital economy and pose a significant cyber risk to businesses. ... [Click on the title's link to continue reading.]

A meal, a smile and a prayer: volunteers venture into the heart of flood-affected areaThe Mountaineer, Waynesville, NC; by Brionna Dallara; 10/23/24 Luke Ross and Louisa Koehring peer out their car window as they snaked down Old Clyde Road, muddy piles of flood debris strewn along the shoulders. With a trunk full of hot meals, they scan for flood-stricken homes, looking for people in their yards or signs of anyone home. Their arrival at homes has been a sure sign of hope. Relief sweeps across the flood victims' faces as Luke and Louisa approach their doorsteps with hot meals or a new pack of under garments. The first stop along their route this day is Ronnie Hall, who was stranded for eight days post-Helene, alone with nothing but his two cats — Famous Amos and Snowflake — to keep him company. Not only do the young couple feed him, but offer him friendship. ... Without power and alone for eight days following the flood, with no one but hospice to check on him, Hall said he persevered with the help of his faith.

3 strategies for hospice GIP compliance Hospice News; by Jim Parker; 10/21/24 Utilization of the general inpatient level of care (GIP) is frequently the subject of audits by Medicare Administrative Contractors (MACs), and avoiding or responding to that scrutiny requires strict compliance to a complex web of rules. Audits are becoming more frequent in the hospice space, and GIP is an increasing focus, including ​for the most common types — Supplemental Medical Review Contractor (SMRC) and Targeted Probe and Educate (TPE). In a survey earlier this year, more than half of hospice providers reported having undergone multiple types of audits within a six-month period. ... In addition to these routine MAC audits, the U.S. Department of Health and Human Services Office of the Inspector General (GIP) has been performing a national audit of GIP utilization, as well as an additional investigation into management of the associated payment cap. The inpatient cap limits the number of days of inpatient care for which Medicare will pay to 20% of a hospice’s total Medicare patient care days, according to OIG. If GIP billing exceeds that metric, the hospice must refund those payments to Medicare.

Music therapist helps patients navigate end-of-life journey on Long Island CBS New York / YouTube; by Jenna DeAngelis; 10/15/24 Music therapy helps with emotional and physical health, and now the healing power of music is being brought to hospice patients on Long Island.

What the heck is a PBM, and why does it matter? Forbes; by Web Golinkin; 10/14/24... [Pharmacy Benefit Managers] PBM BasicsUnless you are a healthcare industry insider—and even if you are— it’s difficult to understand exactly how PBMs work. While they are essentially invisible to the average health plan member, PBMs have a tremendous impact on which medications are covered, the prices paid for these medications, and how patients access them. Here’s a summary of key PBM functions: Formulary Management. ... Negotiating Discounts and Rebates. ... Pharmacy Network Management. ... Claims Processing. ... Clinical Management. ... How PBMs Influence Drug Costs: Rebate System. ... High Deductible Health Plans. ... Prior Authorization and Step Therapy. ... Spread Pricing. ... What Are the Alternatives? ...