Literature Review

HHS sets its sights on $50b in cost savings: Medicare payments to nonhospice providers potentially under fire JD Supra; by Taylor Henderson, Callan Stein, Rebecca Younker; 7/31/25 In May 2025, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) published a review, titled " Potential Cost Savings HHS Programs – HHS Actions," which provided some insight into the OIG's direction to accomplish the Trump administration's stated goal of cutting federal spending. This review spans 35 reports, adding up to $50 billion in potential cost savings — including a reported $6.6 billion in potential savings by preventing Medicare payments for nonhospice items or services furnished to active hospice beneficiaries (nonhospice payments). When a beneficiary qualifies for and elects hospice benefits, the beneficiary signs a statement choosing hospice care over other Medicare-covered treatments for their terminal illness, and the hospice provider is paid a daily, per diem rate to provide these comprehensive services. With nonhospice payments accounting for a significant portion of HHS's potential savings, providers across the health care industry — including nursing and long-term care facilities, hospice and home health agencies, hospitals, individual providers, pharmacies, and medical equipment distributors — will need to be ready for the OIG's possible next steps.

Treasure Coast Hospice announces endowment for pediatric patients WQCS News, NPR for the Treasure Coast, Stuart, FL; by Justin Breckenridge; 7/19/25 The Treasure Coast Hospice Foundation has established a new endowment honoring local philanthropist Marlene K. Filer and her long-standing commitment to children’s health programs in Martin County. ... The Marlene K. Filer Celebrities Fore Kids Endowment will support children and families receiving care through the organization’s Little Treasures Pediatric Program. The program provides comprehensive support for children facing life-limiting illnesses. Filer, founder of Celebrities Fore Kids, has raised more than $3 million since 1997 to support children’s services throughout the region. 

A hospice volunteer has a fascinating new take on people's most common deathbed regret Upworthy; by Cecily Knobler; 8/1/25 ... Over the years, many hospital and hospice workers have paid close attention to what people who are on their deathbeds say. What they're most proud of, and yes, what are their main regrets. ... [This author refers to] Jancee Dunn's New York Times article, "3 Lessons for Living Well, from the Dying." In it, she discusses her friend who is a hospice volunteer. "She hears one regret over and over from patients: letting relationships wither. They wish that they had made more plans with good friends, or they thought about getting back in touch with an old buddy, and talked themselves out of it." ...  One wrote,"My mother always told me, 'Your friends will get you through life.'"Editor's Note: What friend do you want to reach out to, today? 

Hospice of Humboldt expands services Redwood News, Eureka, CA; 7/31/25 ... Through a fundraising effort called the Compassionate Growth Campaign, Hospice of Humboldt was able to raise $750,000, enough to recruit another team of caregivers and double the capacity of the hospice house. “It was a heavy lift for our organization. We recruited and trained an additional 19 staff members,” Keating said. Doctor Charles Knoll, the medical director on campus, walks families through the process. 

Combining clinical insight and data-driven expertise: The case for morning huddles in primary care HEAL Security; by Becky Trotter and Aliya Ali; 7/1/25 The daily huddle, also called a morning huddle, is a brief standup meeting commonly associated with inpatient and surgical care. In these settings, safety is the predominant focus of the meeting. However, the same idea can be used in primary care settings to get care teams ready for the patients scheduled for that day. Morning huddles are an opportunity to merge clinical knowledge with data and analytics to help ensure primary care teams are aligned and specific care needs are recognized before patients walk into the practice. Editor's Note: Is this practice so new? Back in the 1990's at Hospice & Palliative Care of Louisville, each morning began with going through my hospice voicemail box for our well-oiled system of receiving and replying to voicemails for the whole team or individual members, from on-call staff, from leaders from throughout our organization, or other voicemails. These first-thing-in-the-morning communication/tech "huddles" were so crucial then--and are important today (with better tech and data)--because our patients often die during the night. Or, a new patient must be assessed. Or, the patient was transferred from home to an inpatient unit. Or, you know the common, literally life-changing needs. Is your hospice behind the times or leading the way with today's clinical communications and data?

Andwell Health Partners CEO: Medicare Advantage becoming  ‘failed policy,’ jeopardizes home health accessHome Health Care News; by Morgan Gonzales; 7/21/25 The rise of Medicare Advantage (MA) has reshaped the home-based care landscape, but it’s putting home health providers in precarious positions while increasingly failing to deliver for beneficiaries. That’s according to the leader of Lewiston, Maine-based nonprofit provider Andwell Health Partners, which has significantly changed the way it cares for patients, including adjusting care plans, to adjust to increased penetration of MA. Andwell Health Partners’ CEO Ken Albert said MA is rapidly becoming a “failed policy,” on a recent episode of Home Health Care News’ Disrupt podcast. Formerly known as Androscoggin Home Healthcare + Hospice, Andwell Health Partners offers home health care, palliative care, hospice services and a slew of other services across Maine. Albert sat down with HHCN to discuss how the nonprofit will survive industry headwinds, the new service lines and innovations he has plotted for the organization, the future of Medicare Advantage and how nonprofit providers have to innovate to survive. 

How health care systems shape end-of-life care—A step toward transparencyJAMA Network Open; by Jacqueline M. Kruser, Gordon D. Rubenfeld; 7/25Our health care systems, in all their multifaceted complexities, are more influential in shaping the delivery of care than individual human effort or error. Influential system-level factors span many different domains: how we are paid, the buildings we work in, the technology around us, who and how many we have on the team caring for patients, our workload, and our local social networks of influence. One pragmatic first step in addressing the problem of invisible, inaccessible, and/or inflexible patterns of end-of-life care is to build awareness of and foster transparency about the current patterns and their default orientation. Building from this deeper understanding of how our everyday routines and practice patterns influence care, we can then take the bigger step of intentionally designing our routine clinical practice patterns to be systematic yet flexible in their support of patients with serious illnesses.

Simulating the overall hospital quality Star ratings with random measure weightsJAMA Network Open; by Benjamin D. Pollock, Daniel S. Ubl, Subashnie Devkaran, Sean C. Dowdy; 7/25We found that only 244 US hospitals achieved reliable excellence in hospital quality in 2024 when defined as 90th percentile performance or better in at least 50.0% of 100,000 simulations using random weights for each measure in the CMS Overall Star Ratings. Our analysis highlights that there is meaningful variation in hospital quality performance across the spectrum of quality measures, even among 5-star hospitals. Future efforts to assess this variation may allow for better identification of reliably excellent hospitals, which could in turn lead to solicitation of evidence regarding the processes or cultures that separate reliable excellence from inconsistent greatness in hospital quality.  

System wide goals of care implementation: A podcast with Ira Byock, Chris Dale, and Matt GonzalesGeriPal podcast; by Eric Widera, Alex Smith, Ira Byock, Chris Dale, Matt Gonzales; 7/24/25Most health care providers understand the importance of goals-of-care conversations in aligning treatment plans with patients’ goals, especially for those with serious medical problems. And yet, these discussions often either don’t happen or at least don’t get documented. How can we do better? In today’s podcast, we sit down with Ira Byock, Chris Dale, and Matthew Gonzales to discuss a multi-year healthcare system-wide goals of care implementation project within the Providence Health Care System. Spanning 51 hospitals, this initiative [found] an increase from 7% to 85% in goals of care conversation documentation for patients who were in an ICU for 5 or more days. How did they achieve this? Our guests will share insights into the project’s inception and the strategies that drove its success, including:

When grief involves trauma − a social worker explains how to support survivors of the recent floods and other devastating losses The Conversation; podcast by Gemma Ware with Dr. Liza Lane; 7/17/25 The July 4, 2025, floods in Kerr County, Texas, swept away children and entire families, leaving horror in their wake. Days later, flash floods struck Ruidoso, New Mexico, killing three people, including two young children. ... When death is sudden, violent, or when a body is never recovered, grief gets tangled up with trauma. In these situations, people don’t only grieve the death. They struggle with the terror of how it happened, the unanswered questions and the shock etched into their bodies. I’m a social work professor, grief researcher and the founder of The Young Widowhood Project, a research initiative aimed at expanding scholarship and public understanding of premature spousal loss. Both my personal loss and professional work have shown me how trauma changes the grieving process and what kind of support actually helps. To understand how trauma can complicate grief, it’s important to first understand how people typically respond to loss.

My doctor asked if anyone in my family suffers from mental illness. I said, "No, we all seem to enjoy it!"

National Alliance for Care at Home hosts inaugural Financial Summit National Alliance for Care at Home, Alexandria, VA and Washington, DC; Press Release; 7/30/25 The National Alliance for Care at Home (the Alliance) successfully hosted its inaugural event, the 2025 Alliance Financial Summit, July 27-29 in Chicago, IL. The Summit brought together financial leaders from across the care at home community, with expert-led sessions, peer collaboration, and insights into market shifts and emerging technologies. More than 700 attendees and exhibitors participated in the comprehensive program, which featured keynote presentations, concurrent educational sessions, networking opportunities, awards, and celebration. ... “This first Alliance event exceeded our expectations, bringing together care at home leaders from across the nation to connect, learn, and recommit to our shared vision of an America where everyone has access to the highest quality, person-centered healthcare wherever they call home,” said Alliance CEO Dr. Steve Landers.