Literature Review

ASCO palliative care expert panel provides recommendations to integrate health equity into guideline development OncLive, Cranbury, NJ; by Kyle Doherty; 9/4/24 The ASCO Palliative Care Expert Panel [American Society of Clinical Oncology], in collaboration with ASCO’s Health Equity and Outcomes Committee, has published recommendations for integrating health equity measures into future guideline updates. Recommendations advocated for partnerships with increased representation from historically marginalized groups and patient and community-based advocates; a reinforcement of implicit bias training for Expert Panel members as a component of guideline preparation; stratified recommendations and/or guidelines for additional groups; and the review and appraisal of future recommendations by the Expert Panel, patient as well as community advocates, and ASCO reviewers for the inclusion of proper health equity measures before publication.

Humana to depart 13 Medicare Advantage markets Modern Healthcare; by Lauren Berryman; 9/4/24 Humana previewed its Medicare Advantage strategy for the coming plan year, including a decision to quit 13 counties where performance has been unsatisfactory, at the Wells Fargo Healthcare Conference on Wednesday. The Medicare Advantage heavyweight, which had 6.2 million members in those plans as of the second quarter, expects to lose a few hundred thousand enrollees in 2025 as it prioritizes profitable markets, Chief Financial Officer Susan Diamond told investors at the event in Everett, Massachusetts. In addition to leaving those 13 counties, Humana will offer fewer plans in some other areas, Diamond said. About 560,000 members will have to choose new policies for 2025, most of whom will have other Humana plans available to them, she said. ... Diamond did not specify what markets will be affected, but Humana will continue selling Medicare Advantage plans in every state. The company is committed to a presence in certain favorable regions, including south Florida, she said. 

Grief redoubled by a death certificate delayed: A seven-week odyssey in search of a vital record The Provincetown Independent; by Aden Choate; 9/4/24 Richard Pask, 72, came to the select board on Aug. 27 distraught. His wife, Carol Harris, 69, who had ALS, had died at home in hospice care on July 18, he said, and the town had still not issued a death certificate. Without the certificate, Pask could not access his late wife’s pension payments, manage their mutual assets, update annuity contracts, or cancel service accounts in her name. The Social Security Administration, which has continued to issue payments to Harris — a death certificate is required to stop them — had launched an investigation into possible fraud, ...Editor's note: Root causes from this complex case study relate to the family having used a "green burial" which is becoming more common, where permitted. This case study represents a gap in collaboration between typical systems. Hospice personnel who have any 'touch-points" with the death certificate process must know and adhere to federal, state, and local policies and procedures, especially when variables occur (such as green burials). 

Healthcare private equity transactions under scrutiny: Midyear review Healthcare Business Today; by Editorial Team; 9/4/24 Highlights

Medicare Advantage vendors brace for supplemental benefits cutsModern Healthcare; by Lauren Berryman; 9/4/24Companies that have profited from the largesse of Medicare Advantage insurers seeking to lure customers with generous perks are looking ahead to a tough 2025. Humana and CVS Health subsidiary Aetna are among those signaling that curtailing supplemental benefits such as transportation, fitness memberships, in-home support services, and vision, dental and hearing coverage will be a key part of their strategies to restore margins in a business troubled by high costs and a more restrictive regulatory environment.

Henry Ford Health to take over 8 Ascension hospitalsModern Healthcare; by Dustin Walsh; 9/4/24A joint venture between Henry Ford Health and Ascension Michigan will launch on Oct. 1, a spokesperson for Henry Ford Health confirmed to Crain’s. Under the no-cash deal, eight Ascension and Genesys hospitals and an addiction treatment center will be rebranded under Henry Ford Health.

“What I wish I knew about hospice”: A Cleveland Clinic palliative care physician’s insights The Healthy; by Dr. Patricia Varacall, DO; 9/3/24 End-of-life care is deeply personal and incredibly complex. An expert MD shares essential insights on hospice: "At its core, is about human connection." … Laura Hoeksema, MD, MPH, FAAHPM, medical director of Cleveland Clinic Hospice and staff physician in the department of palliative and supportive care, explains the importance of hospice: “Death is a part of life just as much as birth is. When time becomes limited, patients need to be able to spend time in a way that’s meaningful to them.” ... Dr. Hoeksema emphasizes that choosing hospice care is exactly that—a choice. The team offers additional support, guiding patients and their families through the last months of life. ... “When a patient has a serious illness, it’s common for their illness to become the primary focus,” reflects Dr. Hoeksema. The constant anticipation of how the disease might progress can create overwhelming anxiety. With hospice, the illness recedes into the background, allowing the emphasis to be on caring for the person as a whole. ... “The most profound healing I’ve witnessed as a physician has been in patients receiving hospice care,” Dr. Hoeksema adds. She recalls seeing families reconcile after years of tension and others coming together after long periods of distance. The joy on a patient’s face when surrounded by loved ones, laughing and reminiscing, is what it’s all about. “Hospice care, at its core, is about human connection.”

Aroostook House of Comfort hosts Remembrance Way Memorial Garden & Pathway dedication The County, Presque Isel, ME; 9/2/24 On Saturday, August 24 the Aroostook Hospice Foundation hosted its annual Remembrance Way Memorial Garden &  Pathway Dedication Ceremony at the Aroostook House of Comfort Gazebo, a touching event that brought together families and friends to honor the memory of their loved ones. This year’s ceremony featured the dedication of 38 new stones, a bench, wind sculptures and one mini garden, each carefully personalized to celebrate the lives they represent. ... The Remembrance Way is more than just a garden — it’s a meaningful tribute and a vital part of the Aroostook House of Comfort’s mission.

After successful IT career, Denise DeLeo finds new meaning in teen hobby LNP / LancasterOnline, Lancaster, PA; by Karyl Carmingnani; 9/4/24 For 50 years, the Lancaster New Era ... highlighted the accomplishments and aspirations of local high school students in a weekly feature known as Teen of the Week. This is one of a series of stories in which we catch up with some of those students highlighted 50 years ago, in 1974, to see how their lives met their teenage goals and what they would tell today’s high school students. When Denise Weitzel was featured as a Teen of the Week in 1974, the bright-eyed 18-year-old had spent three months as an exchange student in a speck of a town in Denmark, was an avid seamstress, ... [Denise] DeLeo got her first sewing machine when she was 12, and made a lot of her clothes growing up. ... DeLeo had an illustrious career in IT, becoming vice president for an information company. But tragedy struck when a disgruntled employee at one of her company’s clients returned to the workplace and gunned down nine people, including her boss. DeLeo decided to leave the industry and help raise her granddaughter instead. And get back to what she loves: sewing. DeLeo also makes memory bears for hospice families. She uses clothing from the deceased person to make personalized keepsakes for family members. 

“Rehabbed to Death” in oncology: Where do we go from here?JCO Oncology Practice; by Daniel E. Lage, Craig D. Blinderman, Corita R. Grudzen; 9/3/24You can go to rehab to see if you get stronger for chemo. These are words that every clinician caring for hospitalized patients with cancer has heard or said countless times. And yet, especially when it comes to older adults with advanced solid tumors, less than a third of these patients will ever receive systemic therapy again. Furthermore, their symptom profile is more similar to those discharged to hospice than to those discharged home, and they face debilitating functional decline and early mortality—leading some to coin the term “rehabbed to death” to describe this phenomenon. We suggest a few keys area of focus: (1) reframing hospital discharge conversations, including incorporating practices of disclosing prognoses using validated tools or other algorithms; (2) empowering team-based care and inclusion of palliative care clinicians in the SNF setting; and (3) identifying patients failing to make functional progress early. [Also see accompanying article: Respect for the Patient-Oncologist Relationship May Limit Serious Illness Communication by Acute and Postacute Care Clinicians After Discharge to a Skilled Nursing Facility by Sarguni Singh, Ashley Dafoe, John Cagle, Elizabeth R. Kessler, Hillary D. Lum, Brooke Dorsey Holliman, Stacy Fischer.]

A wave of change is coming for healthcare benefits — are hospitals ready? Becker's Hospital CFO Report; by Jakob Emerson; 9/3/24Surveys of employers are making one thing clear: Healthcare costs are rising faster than they did before the pandemic, and those costs are being driven by inflation, the increasing use of weight loss medications, and higher overall medical expenses.  ... As financial pressures mount, many employers are exploring or expanding alternative payment and coverage models, a trend that could significantly alter hospital's revenue streams. ...  The average cost of employer-sponsored coverage is expected to jump 9% from 2024 to 2025, according to estimates from Aon published in August. Healthcare costs per employee are projected to surpass $16,000 per employee in 2025, driven by rising employment levels, inflation and rising pharmaceutical costs. In 2024, employers budgeted an average of $14,823 per employee for healthcare costs. These costs have risen by more than 20% over the past five years and by 43% over the past decade.

Private equity ownership of US hospice centers boomed in recent years – studyThe Guardian; by Jessica Glenza; 9/3/24Investors spent about $1tn buying healthcare facilities over last decade, leading to reports of worsening patient care. Private equity investors are increasingly buying up hospice centers – healthcare facilities meant to focus on pain relief and emotional support for people near the end of their lives. The new study was published in the journal Health Affairs [Private equity acquisitions of hospices are increasing; Ownership remains opaque, by Melissa D. Aldridge, Lauren J. Hunt, Zelle Halloran, and Krista L. Harrison] and provides more evidence of how private equity have acquired firms using often sophisticated and opaque ownership structures. Although for-profit ownership is not new in US healthcare, the surge of private equity ownership is. Such investment groups have spent an estimated $1tn over the last decade, buying up hospitals and doctors’ offices.