Literature Review

Why not-for-profit health systems need positive margins: Deloitte Becker's Hospital CFO, by Andrew Cass; 2/28/24Health system margins are the "lifeblood of a healthy, patient-centered, innovative health care system and community," according to a report from consulting firm Deloitte.  "Claims that profits are not important in fact undermine the ability to fund the mission, serve the community, and deliver better, equitable care," Deloitte said in the report. ... "[Systems] should consider a holistic approach that integrates margin drivers to create a balanced transformation portfolio, according to the report. Timing and sequencing are important within each driver and "a full understanding of the dollar impact and priority of each is necessary for margin improvement to be successful."

(Private Equity Issue) Anesthesiology group must cut ties with 5 hospitals: Colorado AGBecker's Hospital Review, by Alan Condon; 2/27/24Colorado Attorney General Phil Weiser has announced an agreement with U.S. Anesthesia Partners that resolves the private equity-backed company's alleged anticompetitive business practices that drove up prices for consumers receiving surgical anesthesia services.Publisher's note: Private equity concerns have impacted hospices the past few years. Private equity concerns in other fields are also catching our attention.

The devil’s in the details: Hospice providers face Claim Denials for Election Statement technicalities JDSupra, by Lanchi Nguyen Bombalier and Charmaine Mech; 2/29/24Since the Centers for Medicare & Medicaid Services (“CMS”) paused much of its audit activity during the COVID Public Health Emergency, the most recent rounds of Medicare audit activity may represent the first “look” at the new Election Statement forms that many hospice providers adopted under the new Medicare election statement requirements effective in October 2020. Unfortunately, these initial audit results from the Medicare Administrative Contractors (“MACs”) suggest that hospice providers and MAC reviewers may not necessarily see eye-to-eye on what information must be included in the new Election Statement.

False Claims Act - 2023 Year in ReviewJD Supra; by William Athanas, A. Lee Bentley III, Gene Besen, Ryan Dean, Jonathan Ferry, Daniel Fortune, Giovanni Giarratana, Ty Howard, Elisha Kobre, Anna Lashley, Gregory Marshall, Lyndsay Medlin, Stephen Moulton, Ocasha Musah, Scarlett Singleton Nokes, Cara Rice, Brad Robertson, Tara Sarosiek, Jack Selden, Erin Sullivan, Courtlyn Ward, Virginia Wright; 2/28/24As we do every year, this issue revisits the key cases and other developments from the year gone by. And by most metrics, 2023 was a notable year for the False Claims Act (FCA).

March is a tomboy with touseled hair, a mischievous smile, mud on her shoes, and a laugh in her voice. - Hal Borland

Writing condolence cards supports nurses as well as deceased patients’ families ONS Voice, by Casey S. Kennedy; 2/29/24During extended treatment and end-of-life care, patients, their family and caregivers, and the healthcare team can form close bonds and relationships. Those ties are abruptly severed when a patient dies, leaving each party to grieve alone. For healthcare professionals, sending a condolence card can provide closure for themselves and support for a deceased patient’s family, a team of nurses reported in an article published in the December 2023 issue of the Clinical Journal of Oncology Nursing.

How to help elderly parents from a distance: Tech can ease logistical, emotional burden USA Today, by Marc Ramirez; 2/28/24 As a neuropsychologist trained in developing technology for cognitively impaired older adults, Alyssa Weakley’s research at the University of California, Davis, made her acutely aware of the challenges of long-distance caregiving. ... Soon, she and her family found themselves in a position shared by nearly 6 million other Americans, acting as caregivers from a complicated and often distressing distance. According to a 2020 AARP report, long-distance caregivers represent more than 1 in 10 of the country’s estimated 53 million family caregivers, meaning they live an hour or more from their care recipient; on average, they live about 450 miles away. Editor's Note: What systems do you have in place to communicate with and support family members who live long-distance, who never have the opportunity to meet with any hospice team members in person? 

With Amedisys deal pending, Justice Department opens antitrust investigation into UnitedHealth Group Home Health Care News, by Andrew Donlan; 2/27/24The Department of Justice is targeting UnitedHealth Group (NYSE: UNH) in an antitrust investigation, The Wall Street Journal reported Tuesday. Specifically, the Justice Department is interviewing subjects around interactions between UnitedHealth Group and its health care provider services arm, Optum.

House set to vote on bill that could give dramatic boost to nurse-aide training efforts McKnights Long-Term Care News, by Josh Henreckson; 2/28/24 A bill that could reshape how new workers enter the long-term care workforce is scheduled for a vote in the US House of Representatives this week, according to a spokesperson for House Majority Leader Steve Scalise (R-LA). If passed, HR 6585 — referred to as the Bipartisan Workforce Pell Act — would make work training programs of as short as eight weeks with a minimum of 150 hours of training eligible for the federal aid through the Pell Grant program. Previously, grants were available only to programs with a minimum of 15 weeks and 600 hours of training.

How death doulas support entire familiesCure, by Alex Biese; 2/27/24... Death doulas, also known as end-of-life doulas, “provide companionship, comfort, and guidance to those facing a terminal illness or death” via non-medical holistic support encompassing “emotional, spiritual, and practical care,” according to the International End-of-Life Doula Association.

Are we consulting, sharing care, or taking over? A conceptual frameworkPalliat Med Rep, by José Pereira, Christopher Klinger, Hsien Seow, Denise Marshall, Leonie Herx; 2/23/24Background: Primary- and specialist-level palliative care services are needed. They should work collaboratively and synergistically. Although several service models have been described, these remain open to different interpretations and deployment.Aim: This article describes a conceptual framework, the Consultation-Shared Care-Takeover (C-S-T) Framework, its evolution and its applications.

Right-sizing interprofessional team training for serious-illness communication: A strength-based approach PEC Innvov, by Liana Eskola, Ethan Silverman, Sarah Rogers, Amy Zelenski; distributed 2/28/24Objective: Palliative care communication skills help tailor care to patients' goals. With a palliative care physician shortage, non-physicians must gain these serious illness communication skills. Historically, trainings have targeted physician-only groups; our goal was to train interprofessional teams.