Literature Review

Bloom where you’re planted, even on a Monday in July.

CMS proposes expanded authority to revoke Medicare privileges TechTarget; by Jacqueline LaPointe; 7/6/26 CMS proposes expanding its authority to revoke Medicare providers in fraud crackdown, while updating home health payments with a 2.4% increase and continued PDGM adjustments. The Trump administration wants to double down on its healthcare fraud, waste and abuse crackdown. This time, policymakers are seeking to expand CMS' powers to remove providers from Medicare -- a move that the agency says will save taxpayers about $82 million a year. The added capabilities are part of the Calendar Year 2027 Home Health Prospective Payment System Proposed Rule (CMS-1844-P), which CMS released ahead of the July 4th weekend.

The hidden healthcare workforce: why family caregivers are essential to the future of care Healthcare Business Today; by Lance A. Slatton; 7/7/26 Healthcare leaders across the United States are confronting a convergence of challenges unlike any in recent memory. Workforce shortages, rising healthcare costs, increasing patient complexity, chronic disease management, and a rapidly aging population are placing unprecedented demands on healthcare systems. As organizations search for solutions to improve outcomes, reduce costs, and maintain quality of care, one of the most important components of the healthcare ecosystem continues to be overlooked. Family caregivers. ... In many cases, they serve as the connective tissue holding an entire care plan together.

Hospice & Palliative Care of the Piedmont announces Dr. Nancy Hart Wicker as chief executive officer and chief medical officer Index Journal; by Staff Writer; 7/2/26Hospice & Palliative Care of the Piedmont [Charlottesville, VA] has appointed Nancy Hart Wicker, MD, FAAHPM, as chief executive officer and chief medical officer, effective immediately. Hospice & Palliative Care of the Piedmont is the only locally governed, nonprofit hospice in the region with a CMS five-star rating, indicating the highest quality of care. The organization brings 45 years of service, clinical expertise, and community-based decision-making from its clinical staff, leadership, and volunteer board of directors.

Medicare Advantage insurers deny prior authorization requests for post acute care at substantially higher rates than the overall denial rate KFF; by Jeannie Fuglesten Biniek, Meredith Freed, and Juliette Cubanski; 7/6/26 The OIG recently published two reports finding that Medicare Advantage insurers deny more than half of all prior authorization requests for the most expensive types of post-acute care, including 65% of requests for stays in long-term care hospitals (LTCHs) and 54% of requests for stays in inpatient rehabilitation facilities (IRFs), as well as 12% of requests for stays in skilled nursing facilities (SNFs).

[Canada] Palliative care is a fundamental human right TroyMedia; by Rebecca Vachon; 7/6/26 ... Despite the fact that everyone dies, and despite the fact that something like 180,000 Canadians and their families interact with some form of end-of-life care in a year, I keep confronting the perception that palliative care is a niche issue, not one of broad interest. But this reaction only underscores the poll's findings: namely that many Canadians continue to misunderstnad what palliative care is and isn't. On a more positive note, however, when Canadians do understand it, palliative care is, in fact, identified as a priority issue.

The hidden cost of cancer's end: how financial strain shapes final months of care Fred Hutch Cancer Center, University of Washingon, Seattle, WA; by D. Moosavi; 6/25/26 ... Previous Fred Hutch research has shown that people with cancer are more than twice as likely to file for bankruptcy, and nearly twice as likely to experience what researchers call an “adverse financial event,” compared with people who don’t have cancer. But most of that earlier work focused on financial hardship as an outcome caused by cancer. This study flips the question: once someone is already dealing with financial strain, what happens to the care they receive as their illness progresses?Publisher's note: This study also notes Fred Hutch researchers are already exploring this idea through an ongoing study called CREDIT, which is testing whether connecting patients with advanced cancer to financial navigation services can improve their care and reduce unnecessary emergency room and hospital use. Could hospices do something similar?

Sunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!

Implementation of a serious illness conversation program in a health system: A retrospective observational studyJournal of Palliative Medicine; by Glen Varns, Abbey Sidebottom, Katy Hentges, Sandra Castro-Pearson, Jan Richardson, Emily Downing; 6/26Serious illness conversation (SIC) is a structured conversation framework designed to improve shared decision making and promote goal-concordant care with patients anticipating end-of-life care decisions. Objective: Examine reach, timeliness, and quality of SIC implementation across a health system after implementation of a SIC Program (SICP) [and] examine factors associated with SIC completion for eligible patients. Factors associated with SIC included palliative care visits ... , a primary care provider in the system ... , and an inpatient admission with discharge to home care ... Patients with dementia ... were less likely to have SIC. Conclusion: Systemwide implementation of an SICP engaged [only] half of eligible patients; many of those had multiple documented conversations prior to death.

Impact of specialized pediatric palliative care on bereaved parents' mental and physical healthJournal of Pain & Symptom Management; by Claudia Delgado-Corcoran, Huong D. Meeks, Sarah E. Wawrzynski, Barry P. Markovitz, Brandy Harman, Jasmine R. Masih, Kuan Li, Mark Harousseau, Dominic Moore, Jacob Wilkes, Stefanie G. Ames; 6/26Pediatric death can lead to long-term adverse effects on parents’ health. [In this study] of 776 deceased children linked to 773 mothers and 711 fathers, 36.1% received a SPPC [specialized pediatric palliative care] consultation prior to death. Higher rates of mental and physical health burden were observed in mothers than fathers across all time points. Lack of SPPC was associated with increased risks for new mental and physical health burden for mothers within 12 months after the child’s death ... Conclusions: Bereaved parents, especially mothers, experienced new mental and physical health burden up to 24 months after a child’s death.

Palliative care for older adults with hip fracture: An explanatory sequential mixed-methods studyJournal of Pain & Symptom Management; by Daniel I Hoffman, Sydney Moore, Amanda J Reich, Christina Sheu, Mengyuan Ruan, Masami Tabata-Kelly, Kate Sciacca, Tamryn F Gray, Daniel Dohan, Charlotta Lindvall, Zara Cooper; 6/26After hip fracture, older adults experience burdensome treatments and high mortality; they may therefore benefit from palliative care (PC). Among 1,433 hip fracture admissions, GOCC [goals of care conversations], hospice discussions, and specialty PC were documented in view on their role in GOCC. Conclusion: Limited standardization, role uncertainty, and cultural factors limited PC documentation and delivery, highlighting opportunities to strengthen PC integration in surgical care.

Outcomes for hospitalized patients with comfort measures only ordersJournal of Palliative Medicine; by Gina Piscitello, Donna Durant, Tami Minnier, Marika Haranis, Robert M Arnold, Jane Schell; 6/26Clinicians place comfort measures only (CMO) orders for hospitalized patients at the end-of-life when a decision has been made to focus on patient comfort and allow the natural dying process to occur. Our primary aim was to assess the associations of specialty palliative consults (SPC) or documented goals of care conversations (GOCC) with in-hospital mortality among patients with CMO orders. Of 6,789 hospitalized patients with CMO orders ... seventy-three percent died in-hospital, and 22% were discharged with hospice. SPC placed anytime during hospital admission were associated with lower in-hospital mortality ... and higher discharge with hospice ... In contrast, documented GOCC anytime during admission were associated with higher in-hospital mortality ...  and lower discharge with hospice ...

Survival variation and predictors of length of stay in US hospice patientsInternational Perspectives and Future Directions for Practice, Research, and Policy; by Ian Duncan, Xiyue Liao, Terri Maxwell; 6/26End-of-life (EOL) patients in the US Medicare program represent a large and growing population, as well as a disproportionate share of Medicare’s costs. Survival of patients in hospice is, however, highly variable, implying an opportunity for improved management by enhancing the prediction of survival. Actuaries, health economists, policy analysts, and health services researchers have studied expenditures at the EOL for Medicare decedents for many years, finding that survival at EOL is highly variable. We discuss the utilization of hospice benefits for patients at the EOL in the United States.