Downside risk, upside payment highlight new CMS innovation agenda
Modern Healthcare; by Bridget Early; 5/13/25
The Centers for Medicare and Medicaid Services is rolling out a broad new agenda for its innovation center that could lead to requirements that participants in value-based care programs to take on downside risk, the agency announced ... The Center for Medicare and Medicaid Innovation plan prioritizes shared risk and prospective payments, streamlined quality measurement, artificial intelligence and other technologies, and Medicare Advantage payment models, Director Abe Sutton said in an interview Friday [5/9]. Notably, CMS is walking away from a goal set four years ago to have all fee-for-service Medicare beneficiaries under accountable care arrangements by 2030, Sutton said. CMS provided Modern Healthcare an advance look at the new innovation center platform. ... Designing models that require providers to accept at least some downside risk could be the most consequential action stemming from the plan. Subjecting participants to potential financial losses, not just potential benefits, is key to driving cost savings and quality improvement, Sutton said.

AI tool uses face photos to estimate biological age and predict cancer outcomes 
Mass General Brigham - Technology & Innovation - Research; by Hugo Alerts, Ray Mak, Dennis Bontempi, Osbert Zalay, Danielle S. Bitterman, Fridolin Haugg, Jack M. Qian, Hannah Roberts, Subha Perni, Vasco Prudente, Suraj Pai, Christian Guthier, Tracy Balboni, Laura Warren, Monica Krishan, and Benjamin H. Kann; 5/8/25 
Mass General Brigham findings suggest FaceAge tool could provide objective data to help inform treatment decisions in cancer care and other chronic diseases. Eyes may be the window to the soul, but a person’s biological age could be reflected in their facial characteristics. Investigators from Mass General Brigham developed a deep learning algorithm called FaceAge that uses a photo of a person’s face to predict biological age and survival outcomes for patients with cancer. They found that patients with cancer, on average, had a higher FaceAge than those without and appeared about five years older than their chronological age. Older FaceAge predictions were associated with worse overall survival outcomes across multiple cancer types. They also found that FaceAge outperformed clinicians in predicting short-term life expectancies of patients receiving palliative radiotherapy. Their results are published in The Lancet Digital Health.
Editor's note: This summary article is published by the main source, Mass General Brigham. Various articles are being written about this new use of AI.

• The Lancet  Digital Health (the full research article): FaceAge, a deep learning system to estimate biological age from face photographs to improve prognostication: a model development and validation study
• The New York Times: Can a photograph help predict who will survive cancer treatment?
• The Washington Post: New AI tool predicts your biological age from a selfie
• Health Medicine Network: HMN2025 - How AI instrument makes use of selfies to foretell organic age and cancer survival
• Inside Precision Medicine - Patient Care: AI tool predicts cancer survival from face photos
• Bioengineer: AI tool analyzes facial images to estimate biological age and forecast cancer prognosis

Nonprofit hospice home offers free, 24/7 end-of-life care to unhoused, low income 
Albuquerque Journal, Albuquerque, NM; by Gregory Hasman; 5/12/25 
Dorothy Marquez has spent the last month with her brother Gerald Moya in a Downtown Albuquerque hospice home, reminiscing about their childhoods or his lime green 1964 Chevrolet Impala lowrider he loved to show off. Moya, 59, is battling stage 4 lung cancer and has days to live. ... Inhora is doing its best to ensure Moya feels comfortable. "I'm very happy because he's not in pain and he's not out there just laying on the road because that's what he'd probably be doing because we don't have a place to go," Marquez said. "We're both homeless." Since April, the hospice home on Tijeras NW, near Seventh Street, has served as a place for people who are unhoused or have low incomes to spend their final days with loved ones. "Our culture throws dying people away and hides them behind closed doors," said Miles Gloetzner, Inhora's founder and executive director. ""And they deserve better. They deserve dignity and compassion, ..."

Thrift shop to benefit hospice patients opens on Charleston's West Side 
Charleston Gazette-Mail, Charleston, WV; by Staff report; 5/10/25, updated 5/12/25 
A new thrift store has opened on Charleston's West Side to benefit West Virginia's largest hospice care agency. Heart to Home Charity Shop is run by more than 100 volunteers of HospiceCare, which is headquartered beside the thrift shop. ... [In] addition to providing revenue to be used for services for HospiceCare's patients and families, the store enables those wanting to give their time to HospiceCare, but are not ready for--or are uncomfortable with--direct patient care opportunities.

Wisconsin Hospice and Palliative Care Council: Applauds state Assembly for approving bill establishing a State Palliative Care Council 
WisPolitics, Kimberly, WI; Press Release; 5/13/25 |
Today, the State Assembly approved Assembly Bill 23, a bill that would establish a state Palliative Care Council.  The Wisconsin Hospice and Palliative Care Association (WiHPCA) strongly supports this legislation, which would ultimately help increase awareness and utilization of this specialized type of medical care throughout the state. The Assembly Committee on Health, Aging, and Long-Term Care voted 14-1 on March 13 to recommend approval of this legislation. This bill would establish a council of individuals with palliative care and other medical expertise to consult and advise the Wisconsin Department of Health Services (DHS) on this type of specialized medical care. In addition, this legislation would require DHS to create a statewide palliative care consumer and professional information and education program, as this type of specialized care is often misunderstood. 

I held my wife's hand as she died. It was the most painful moment in my life, but also the greatest gift.
Yahoo!Life; by Juan Cruz, Jr.; 4/13/25

• My wife was diagnosed with a rare bone cancer and was only given a year to live.
• When she died, I held her hand until she took her last breath.
• Although it was a painful moment, being there helped me grieve and taught me resilience.

My world came crashing down around me when my wife and I heard the word "cancer." It was terrifying for both of us. At the time of the diagnosis, our daughter was just 2 years old. ... The day she passed, I was with her at the hospice. I was sleeping in a chair next to her. I still remember what I was wearing that day: black jeans and an orange sweater. It was around 5 a.m., ... As I continued to hold her hand, I buried my head in the bed and began to cry. Being there when my wife died was a gift. I was there for her last moments, and she wasn't alone. Just like I was there in the labor and delivery room when our daughter was born, I was able to be there when she passed. It was a great sense of privilege that I was able to share those last moments with her in that hospice room.

Team work makes the dream work for hospice veteran 
Veterans Administration, VA.gov; by Douglas A. Etter; 5/12/25 
When Marine Corps Veteran Ivson Shelley came to the Lebanon VA Medical Center for a follow-up visit with his oncologist, Suhail Ali, MD, the staff was concerned about how much the former New York resident had declined since his last appointment. They didn’t think he could be cared for at home any longer, so a decision was made with the family to admit him to the medical center’s hospice unit Thursday afternoon. Once there, the Marine shared a heartfelt wish with the staff – he wanted to marry his lifelong love, Wanda Rivera. The couple had dated more than 50 years ago and rekindled their relationship 10 years ago. Upon hearing the Vietnam Veteran’s wish, the VA team, lead by Hospice Nurse Manager Jessica Himes, RN and Hospice Social Worker, Erin Miller, MSW, LCSW quickly came together to make it happen. Palliative care nurse Melissa Buchinski, RN began to research what the requirements were to secure a marriage license for the couple. ... [Continue reading this inspirational story.]

He was dying, Alabama sent him back to prison anyway 
AdvanceLocal - AL.com - Alabama Media Group; by Renuka Rayasam; 5/12/25 
Brian Rigsby was lying with his right wrist shackled to a hospital bed in Montgomery, Alabama, when he learned he didn’t have long to live. ... Rigsby decided to stop efforts to treat his illness and to decline lifesaving care, a decision he made with his parents. And Rigsby’s mother, Pamela Moser, tried to get her son released to hospice care through Alabama’s medical furlough policy, so that their family could manage his end-of-life care as they saw fit. But there wasn’t enough time for the furlough request to be considered. After learning that Rigsby was on palliative care, the staff at YesCare, a private prison health company that has a $1 billion contract with the Alabama Department of Corrections, told the hospital it would stop paying for his stay and then transferred him back to Staton Correctional Facility in Elmore, according to the hospital record his mom provided to KFF Health News. Moser never saw or spoke to her son again. “The last day I went to see him in the hospital, I was hoping he would take his last breath,” said Moser, a former hospice nurse. “That is how bad I didn’t want him to go to the infirmary” at the prison. A week later, Rigsby died ... in the infirmary, according to his autopsy report. Officials at the corrections department and YesCare did not respond to requests for comment.

Honey, Sweetie, Dearie: The perils of elderspeak
KFF Health News, originally published by The New York Times; by Paula Span; 5/9/25 
A prime example of elderspeak: Cindy Smith was visiting her father in his assisted living apartment in Roseville, California. An aide who was trying to induce him to do something —  Smith no longer remembers exactly what — said, “Let me help you, sweetheart.” “He just gave her The Look — under his bushy eyebrows — and said, ‘What, are we getting married?’” recalled Smith, who had a good laugh, she said. Her father was then 92, a retired county planner and a World War II veteran; macular degeneration had reduced the quality of his vision, and he used a walker to get around, but he remained cognitively sharp. People understand almost intuitively what “elderspeak” means. “It’s communication to older adults that sounds like baby talk,” said Clarissa Shaw, a dementia care researcher at the University of Iowa College of Nursing ... “It arises from an ageist assumption of frailty, incompetence, and dependence.” Its elements include inappropriate endearments. “Elderspeak can be controlling, kind of bossy, so to soften that message there’s ‘honey,’ ‘dearie,’ ‘sweetie,’” said Kristine Williams, a nurse gerontologist at the University of Kansas School of Nursing ...

CMS seeks public input on improving technology to empower Medicare beneficiaries 
CMS Newsroom; Press Release; 5/13/25 
The Centers for Medicare & Medicaid Services (CMS) is taking bold steps to modernize the nation’s digital health ecosystem with a focus on empowering Medicare beneficiaries through greater access to innovative health technologies. The agency, in partnership with the Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology (ASTP/ONC), is seeking public input on how best to advance a seamless, secure, and patient-centered digital health infrastructure. The goal is to unlock the power of modern technology to help seniors and their families take control of their health and well-being, manage chronic conditions, and access care more efficiently. ...

Congress offers new plan for Medicaid cuts, raising fresh concerns among HCBS advocates 
McKnights Home Care; by Adam Healy; 5/13/25 
House Republicans on Sunday [5/11] introduced a new budget reconciliation that outlines exactly how Medicaid cuts could take shape. Home- and community-based services advocates quickly spoke out in opposition to the bill. [Various leaders responded.]

• “The policies in the bill represent dangerous cuts to Medicaid,” Katie Smith Sloan, president and chief executive officer of LeadingAge, said Monday [5/12] in a statement. ...
• The Congressional Budget Office last week estimated that these kinds of changes to the Medicaid program could wipe away coverage for millions of Americans. ...
• Lawmakers are split — mainly down party lines — regarding the budget bill. ...
• “The truth is somewhere in the middle,” Damon Terzaghi, senior director of Medicaid advocacy at the National Alliance for Care at Home ...

Texas lawmakers pass bills to expand Medical Marijuana Program and support psychedelic research 
Marijuana Moment; by Tom Angell; 5/13/25 
The Texas House of Representatives has passed bills to significantly expand the state’s limited medical cannabis program and to support research on the therapeutic potential of ibogaine with the aim of encouraging federal approval of the psychedelic. The marijuana measure cleared the House on third reading with a vote of 122–21 and the ibogaine legislation was approved 138-2. The body’s action sends both proposals to the Senate and comes one day after the bills were given initial approval on second reading. ... A second amendment approved by members would require doctors who issue medical cannabis recommendations to report them to the state’s prescription drug monitoring program.

[Australia] New study amplifies rural voices to improve palliative care at end-of-life 
NewsWise; by University of South Australia; 5/13/25  
... [A] new study from the University of South Australia is shining a light on the experiences of rural South Australians who are navigating end-of-life care, in the hope of improving access to palliative care services and supports in rural and country areas. ... “People living outside of major cities are notoriously under-supported and underserviced when it comes to health care – and palliative care is no different,” Associate Professor Gunn says. “More than seven million Australians, almost 30% of the population, live in rural communities, yet only 16% of the palliative care workforce live and work in these areas. “Research tells us that earlier referral to palliative care services gives patients and families more control, helping them maximise their quality and quantity of life. Yet patients living in country or rural areas have less opportunity to receive specialist palliative care, and this can negatively affect their wellbeing, and the wellbeing of their family members."
Editor's note: Sound familiar? Click here for "Rural Hospice and Palliative Care - Resources," from the Rural Health Information Hub. 

UnitedHealth Group CEO Andrew Witty steps down 
Modern Healthcare; by Shelly Banjo; 5/13/25 
UnitedHealth Group Inc. unexpectedly replaced its chief executive and suspended earnings guidance, raising increasing questions over how the company once regarded as a safe bet by investors has got its cost predictions so wrong. The company brought back Chairman and former CEO Stephen Hemsley for the top role, saying Andrew Witty has resigned “for personal reasons.” The health insurer, whose top insurance executive was murdered in New York last December, also ripped up its 2025 outlook. The meltdown in its outlook blindsided investors yet again. 

 Let your grief be a bridge to the love that remains. ~ Mary Oliver