Literature Review

JUST UPDATED! HOPE Assessment Tool – CMS Question and Answer RepositoryCHAP press release; 8/21/25CMS posted a HOPE Implementation Frequently Asked Questions (FAQs) course in August 2025. The FAQs cover important topics about the transition from the HIS to the HOPE tool, updated reporting requirements, and what providers should prepare for. Access the FAQ course. The following Questions and Answers about the HOPE Assessment tool come from CMS postings on the Hospice Quality Reporting Program (HQRP) Website. CHAP has gathered them in one place and organized them by topic for your convenience. Read Q&As.

Sick doctors: Don’t be the kind of patient you hateMedscape; by Eric Spitznagel; 8/18/25On a frigid November night in 2018, Michelle Sullivan came home from dinner with friends, took the dog out, and suddenly felt something off. “I walked outside, and I could feel my heart go into an odd rhythm,” says Sullivan, an osteopath from southern Illinois whose husband, Bill, is an emergency physician... “I said, ‘I don’t think I have time for an EKG. Something’s really wrong.’” When they hit the ER doors, her heart rate was 180. “I said, ‘I don’t know if I’m going to make it. I feel like I’m going to die right here,’” Sullivan recalls. “They hooked me up, and I said, ‘It’s AFib [atrial fibrillation], isn’t it?’ Yeah. It was AFib.” And then…nothing. No one came in. No crash cart, no orders - and this was her hospital. “Finally, Bill runs out into the hallway and says, ‘I’m sorry, can somebody please get in here?’”Publisher's note: This is part of a Medscape series titled "Dr. Patient" describing what it's like when healthcare professionals become patients. From a hospice perspective, does your hospice provide the quality of care you would want for yourself or a loved one?

Why more doctors can't make ends meetAxios; by Tina Reed; 8/12/25America's doctors are working harder and getting paid less. And that could soon translate into less access for some patients. The big picture: A new report from consultancy Kaufman Hall shows primary care physicians and specialists are delivering more services since the pandemic. But they're not making more money because of stagnant reimbursements from public and private insurers and inflation. The data helps explain why medical practice bankruptcies hit a six-year high last year — and why some providers are shifting to pricey procedures for cash-paying customers to boost their bottom lines.

Guest Voice: What ‘It’s a Wonderful Life’ teaches us about living with MS Multiple Sclerosis News Today; by Donald Kushner, MD; 8/15/25 Donald Kushner, MD, is a retired physician, board certified in internal medicine and hospice and palliative care. He has been living with multiple sclerosis (MS) for more than 20 years and draws on his dual perspective as both doctor and patient to explore illness, identity, and adaptation. He’s writing a book about how people with chronic illness and their support systems can better understand — and talk to — each other. ... George’s story reminds me that resilience often shows up in ordinary moments. That the life we’ve built — even with detours — is still a life of worth.

Black and white older adults’ end-of-life experiences: Does hospice use mitigate racial disparities?The Journals of Gerontology; by Clifford Ross, Brina Ratangee, Emily Schuler, Zheng Lian, Benmun Damul, Deborah Carr, Lucie Kalousová; 7/25Racial disparities in end-of-life care are well documented, but less is known about how these inequalities shape assessments of death quality. Proxies for Black decedents reported higher perceived death quality than those for White decedents, despite evidence of greater structural disadvantage. However, perceived care concordance was significantly lower among Black decedents. Hospice care was associated with improved perceived death quality for Black decedents but not for Whites. When accounting for socioeconomic and death experience controls, hospice care did not moderate perceived care concordance.

Do you care about your legacy? 54% of Americans want to leave mark on the world Study Finds, New York, NY; by StudyFindsAnalysis, reviewed by Steve Fink; 8/15/25 Getting older changes everything, including what we care about most. A new survey of 2,000 Americans reveals ...

How to estimate your EHR implementation cost: Factors that impact your budget Joyrulez; by RickD32; 8/14/25 Implementing an EHR (Electronic Health Record) system is one of the most significant investments a healthcare organization can make. Beyond the obvious benefits of digital recordkeeping—such as improved patient care, streamlined workflows, and regulatory compliance—the financial implications of EHR implementation are considerable. Understanding the factors that influence costs is essential for accurate budgeting and successful project execution. This guide will break down the key considerations, providing insights into an ehr implementation cost breakdown, the roles involved, and hidden expenses that organizations often overlook.

YoloCares: A caring coalition for California The Davis Enterprise; by Craig Dresang; 8/15/25 In his closing remarks at a 2016 stakeholder meeting, hosted by the National Academy of Medicine, Dr. Victor Dzau (academy president) said, “We need a coalition, a movement, a critical mass. We need to work together so that the whole is greater than the sum of its parts. We need to come together to develop resources for policy and communication. We need to improve our communication — to patients and families, healthcare providers, government, and the public.” His words perfectly captured the founding spirit of the Coalition for Compassionate Care of California. ... The group is a small but mighty powerhouse that works closely with healthcare systems and providers, patient advocacy groups, professional associations and policy — and lawmakers to promote high-quality care for seriously ill Californians.Publisher's note: Thanks for your editorial Craig - and a shout out to Jennifer Ballentine and the strong work she and the Coalition are doing!

350 health groups urge Congress to extend Medicare telehealth MedCityNews; by Marissa Plescia; 8/14/25 A group of 350 organizations, including the American Academy of Hospice and Palliative Medicine, are urging Congress to make Medicare telehealth flexibilities introduced during the COVID-19 pandemic permanent, or at least extend them for two years. In a letter to congressional leaders, the organizations emphasize the importance of telehealth for Medicare beneficiaries, particularly those with chronic conditions or in rural areas, and highlight the potential impact on health care access and infrastructure. Guest Editor’s Note, Judi Lund Person: Unless there is Congressional action after the August recess to extend the hospice face-to-face requirement through telehealth, that option will conclude on September 30, 2025.

Make a habit of two things - to help, or at least, to do no harm. ~Hippocrates

Ethical obligations to inform patients about use of AI toolsJAMA; by Michelle M. Mello, Danton Char, Sonnet H. Xu2; 7/25When a health care organization decides to deploy an AI tool, it should decide whether notification or consent is ethically required. To decide that disclosure is not required at the point of care is not to conclude that organizations have no transparency obligations concerning their use of AI. Two complementary steps can help discharge these obligations. First, health care organizations’ websites and written materials distributed to patients should explain how the organization uses AI to deliver better, safer, more efficient care and protect staff well-being. This kind of transparency honors patients’ desire to know how their care may be affected by AI and may help some make decisions about where to seek care. 

Improved outcomes and cost with palliative care in the Emergency Department: Case-control studyThe Western Journal of Emergency Medicine; Brandon Chalfin, Spencer M Salazar, Regina Laico, Susan Hughes, Patrick J Macmillan; 7/25This small pilot case-control study included a subset of all patients referred by emergency physicians and hospitalists for palliative care within 24 hours of registration, physically present in the ED. CONCLUSION: Embedding hybrid physicians in the ED significantly shortened hospital stays and reduced charges for seriously ill patients. A notable secondary outcome was that 26.5% of ED visits in the case group did not result in hospital admission, compared to all controls being admitted ... In addition, more cases than controls had a code status of comfort care at discharge ... These findings support the further exploration of integrating such physicians into ED settings to enhance patient care and optimize hospital resources.