Literature Review

Unanswered questions on private equity in gastroenterologyJAMA Network; by Jane M. Zhu; 6/25A growing literature on private equity (PE) acquisitions of physician practices has found associated increases in health care prices and utilization, but evidence specific to gastroenterology remains relatively new despite the specialty being a popular target for PE. More than 1 in 8 gastroenterology practices are now owned by PE, with practice fragmentation, lucrative procedural reimbursements, and an aging population factoring into continuing investor interest... Taken together with observations of increased utilization, there may be 2 interpretations of the data presented by Arnold and colleagues. One interpretation of the findings may be that PE acquisition may focus on reducing inefficiencies, improving access by expanding practice capacity, and increasing throughput. Another interpretation may be that PE acquisition is focused on the strategic exploitation of market and pricing power. The latter may have less of an impact on clinical measures like quality of care, but potentially, both strategies could be at play.Publisher's note: Similar questions being asked across hospice, gastroenterology, physician practices, and other areas of healthcare.

Physicians' preferences for their own end of life: A comparison across North America, Europe, and AustraliaJournal of Medical Ethics; Sarah Mroz, Sigrid Dierickx, Kenneth Chambaere, Freddy Mortier, Ludovica De Panfilis, James Downar, Julie Lapenskie, Koby Anderson, Anna Skold, Courtney Campbell, Toby C Campbell, Rachel Feeney, Lindy Willmott, Ben P White, Luc Deliens; 6/25Setting: Eight jurisdictions: Belgium, Italy, Canada, USA (Oregon, Wisconsin, and Georgia), Australia (Victoria and Queensland). Participants: Three physician types: general practitioners, palliative care physicians, and other medical specialists. Conclusion: Physicians largely prefer to intensify alleviation of symptoms at the end of life and avoid life-sustaining techniques. In a scenario of advanced cancer or Alzheimer's disease, over half of physicians prefer assisted dying. Considerable preference variation exists across jurisdictions, and preferences for assisted dying seem to be impacted by the legalisation of assisted dying within jurisdictions.

Saturday newsletters focus on headlines and research - enjoy!

[Bogota, Columbia] Anxiety, depression, and quality of life of caregivers of palliative care patients with cancerRevista Cuidarte; by Alejandra María Alvarado García, Lina María Vargas-Escobar, Mauricio Arias-Rojas, Carlos Javier Avendaño-Vásquez, Cesar Antonio Consuegra-Pareja; 2/25Caregivers with moderate or severe depression were more likely to report symptoms of sadness, punishment feelings, self-dislike, suicidal thoughts or wishes, indecisiveness, irritability, changes in appetite, concentration difficulty, and tiredness or fatigue. Among caregivers with mild depression, loss of interest in sex, agitation, and past failure were identified. Strategies for psycho-emotional counseling, education, and support for caregivers are needed.

Re-examining early in early palliative care: Precedent, reality, and future research prioritiesJCO Oncology Practice; by Laura A. Petrillo, Julia L. Agne; 6/25Nearly 700,000 people in the United States are living with metastatic solid tumor malignancies in 2025, a number that continues to grow because of advances in survival-extending therapy. Even with therapeutic advances, however, metastatic cancer continues to negatively affect patients' quality of life because of bothersome symptoms and psychological, social, and spiritual distress. Palliative care is specialized medical care focused on alleviating suffering for individuals with serious illness, including those with advanced cancer. On the basis of on substantial evidence demonstrating its efficacy in improving quality of life, ASCO and other organizations now recommend the early integration of palliative care with oncology care for all individuals living with advanced cancer. [Also see accompanying article: Early Integration of Outpatient Palliative Care Among Adults With Advanced Cancer in a Safety-Net Health System: A Patterns of Care Analysis; by Lisa DiMartino, Vincent Merrill, Celette Sugg Skinner, Timothy P. Hogan, Navid Sadeghi, Alva Roche-Green, Winnie Wang, Arthur S. Hong]

Aroostook House of Comfort’s 12th Annual Golf Classic raises $90,000[ME] The County; 6/20/25The Aroostook Hospice Foundation proudly hosted its 12th Annual Golf Classic on Saturday, June 14 at the Presque Isle Country Club, raising approximately $90,000 in support of the Aroostook House of Comfort. This achievement was made possible through the generous support of 166 sponsors, 42 teams, 42 raffle and prize donors, 14 in kind donors and 32 volunteers who came together to make the day a success.

Avow selected to provide hospice care in Lee, Glades, and Hendry CountiesSouth Florida Hospital News; 6/25/25Avow is proud to announce that the Florida Agency for Health Care Administration (AHCA) has notified Avow of its intent to select the organization to provide hospice services in Lee, Glades and Hendry counties, following AHCA’s preliminary approval of Avow’s Certificate of Need (CON) application. This important decision will expand Avow’s compassionate, high-quality hospice care for residents throughout Southwest Florida.

Hospice care not meant to be a last resort, offers more benefits[NH] The Laconia Daily Sun; by Anna Swanson, Pemi-Baker Hospice & Home Health; 6/24/25Hospice care is often misunderstood. Too many families see it as a last resort — something to turn to only when there’s “nothing else to do.” But at Pemi-Baker Hospice & Home Health, we see it differently. Hospice is not about giving up. It’s about choosing how to live. Hospice care is a gift — a chance to focus on what truly matters when time is short. It’s about comfort, dignity, and presence. It’s about saying yes to meaningful moments and no to unnecessary suffering.

Measuring what matters: The untapped power of resident experienceMcKnight's Long-Term Care News; by Charles de Vilmorin; 6/25/25In today’s senior living and long-term care environment, doing well financially depends on doing good — truly good. Communities that thrive are the ones that deliver on the promise of person-directed living, where residents are not passive care recipients but active participants in a life of dignity, purpose and connection. This isn’t just a moral imperative — it’s a strategic one. The industry has long recognized the importance of resident quality of life, but often fails to define or measure it with the same rigor applied to occupancy or staffing ratios. This is a missed opportunity. Resident experience remains one of the most powerful, untapped levers for operational improvement, competitive differentiation and financial growth. It’s time we treat it like the performance driver it is.Publisher's note: The balance of "mission and money" is equally true in hospice.

Social Media Watch 6/27/25

National health expenditure projections, 2024–33: Despite insurance coverage declines, health to grow as share of GDPHealth Affairs; by Sean P. Keehan, Andrew J. Madison, John A. Poisal, Gigi A. Cuckler, Sheila D. Smith, Andrea M. Sisko, Jacqueline A. Fiore, Kathryn E. Rennie; 6/25/25National health expenditures are projected to have grown 8.2 percent in 2024 and to increase 7.1 percent in 2025, reflecting continued strong growth in the use of health care services and goods. During the period 2026–27, health spending growth is expected to average 5.6 percent, partly because of a decrease in the share of the population with health insurance (related to the expiration of temporarily enhanced Marketplace premium tax credits in the Inflation Reduction Act of 2022) and partly because of an anticipated slowdown in utilization growth from recent highs. Each year for the full 2024–33 projection period, national health care expenditure growth (averaging 5.8 percent) is expected to outpace that for the gross domestic product (GDP; averaging 4.3 percent) and to result in a health share of GDP that reaches 20.3 percent by 2033 (up from 17.6 percent in 2023).

Healthcare’s broken math: 11 signs the numbers don’t add upBecker's Hospital Review; by Scott Becker, Molly Gamble; 6/25/25Healthcare has a daunting and growing supply and demand problem. We have a growing population in the United States and not enough physicians, nurses, allied healthcare providers and technicians. It is a very clear and simple math problem. We have approximately 340 million people in the United States and only about 840,000 direct patient care physicians and about 5.3 million nurses. Similarly, we face shortages across the board in other provider types and critical staff roles. [Imbalances include:]