Literature Review

Estimating the number of services & patients receiving specialized palliative care globally in 2025 Journal of Pain and Symptom Management; by Stephen R Connor, Eduardo Garralda, Vilma A Tripodoro, Carlos Centeno; 7/28/25 online ahead of print ... In 2025, the estimated number of specialized palliative care service delivery teams worldwide reached approximately 33,700 - representing a 32.7% increase from the 25,000 identified in 2017. Service delivery expanded across all WHO regions except Africa. The estimated number of patients served rose from 7 million in 2017 to approximately 10.4 million in 2025. This figure represents roughly 14% of the total global need for palliative care. ... Despite notable growth in service availability, significant disparities persist, particularly in low- and middle-income countries. While over half of the need appears to be met in high-income countries, only 4.4% is addressed by specialist provision in low and middle-income countries. 

Medicare and Medicaid: 60 years of health care reform Medicare Rights Center; by Jisoo Choi; 7/30/25 On this day 60 years ago, Medicare and Medicaid were signed into law, creating a national health insurance program for older adults, people with disabilities, and people with limited incomes. In the first three years, Medicare and Medicaid enrolled nearly 20 million beneficiaries; today, Medicare has an enrollment of over 68 million and Medicaid, over 71 million. The programs, established amidst sustained public pressure and organizing by labor unions and older adults, have been and remain very popular: recent polling shows 82% of American adults hold a generally favorable view of Medicare, and 97% consider Medicaid to be important to people in their local communities.

Crossing Rivers Health hospice service closing after 45 yearsWGLR; by Courtney Chaffee; 7/30/25 An area hospital-based hospice service is closing. Crossing Rivers Health announced this week that it will close its hospice program effective Sept. 30. A press release states that the decision followed “a comprehensive evaluation of healthcare trends.” Crossing Rivers Health is based in Prairie du Chien and the hospice program was established in 1980. It serves patients in Crawford County and portions of Grant County in Wisconsin, as well as patients in portions of Clayton County in Iowa. The release states that Crossing Rivers Health is working with Agrace Hospice Care to help ensure continuity of care for Wisconsin hospice patients. 

National Alliance CEO Dr. Steve Landers: Hospice reform should mean more care, not less Hospice News; by Jim Parker; 7/28/25 Hospice reform efforts should focus on allowing for “more care, not less,” according to National Alliance for Care at Home CEO Dr. Steve Landers. Key elements of this should include home-based respite care and a payment system for high-acuity palliative services that hospice patients often lose out on due to the costs. ... “It means innovation in care, home-based respite services, better payment models for people that need things like dialysis or palliative radiation,” Landers said at the Alliance’s Financial Summit in Chicago. “That is that reform we’re talking about.” ... Landers also said that attempts at hospice reform should not “carve-in” hospice into Medicare Advantage. Bringing hospice under Medicare Advantage would undermine patient choice, adversely impact timely access to care and leave providers with lower reimbursement rates, according to the Alliance, the National Partnership for Healthcare and Hospice Innovation (NPHI) and LeadingAge

S.2287 - Palliative Care and Hospice Education and Training Act Congress.gov, 199th Congress (2025-2026); bill sponsored by Sen. Tammy Baldwin; introduced 7/15/25 Introduction: To amend the Public Health Service Act to increase the number of permanent faculty in palliative care at accredited allopathic and osteopathic medical schools, nursing schools and other programs, including social work, physician assistant, and chaplaincy education programs, to promote education and research in palliative care and hospice, and to support the development of faculty careers in academic palliative and hospice care. [Click on the title's link the full document.]

Where UnitedHealthcare, Humana rule the Medicare Advantage market Modern Healthcare; by Tim Broderick; 7/22/25 Medicare Advantage competition was meager in 97% of counties last year, where beneficiaries could choose among just a handful of dominant insurers. The health policy research institution KFF analyzed Centers for Medicare and Medicaid Services data on the plans available across the U.S. and Puerto Rico in 2024. The findings indicate that Medicare enrollees have few options in most areas. Market share was “highly concentrated” in 79% of counties and “very highly concentrated” in another 18%, KFF found, using metrics similar to those the Federal Trade Commission and the Justice Department employ to measure competitiveness. ... Ninety-three percent of Medicare-eligible people lived in “highly concentrated” or “very highly concentrated” counties. ... [Click here and scroll down for the national map with] the level of Medicare Advantage market concentration for each county and the market share for each county's top insurer.

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. 

Filling the gaps with the loss of Wilshire Health and Community Services NBC KSBY-6, California's Central Coast; by Dylan Foreman; 7/22/25 At the end of June, the longtime medical service provider Wilshire Health and Community Services, which offered everything from hospice and home health care to community services like counseling and transportation, closed its doors, leaving clients looking for help elsewhere. ... [Services] like home health and hospice care are being transferred over to organizations like Dignity Health Home Health and Hospice Care, getting 50% of the patients from Wilshire and sending offers out to 30% of their staff. According to Wilshire, on any given day, they could have at least 250 clients.

Rural hospitals eye service expansions to weather federal cuts Modern Healthcare; by Alex Kacik; 7/14/25 Rural hospitals are hopeful they can add rather than reduce services to help soften the blow from looming Medicaid and Medicare cuts. ...  If rural providers cannot recruit physicians, lean more heavily on philanthropic donors or find other ways to reduce their reliance on Medicaid and Medicare reimbursement to get ahead of cuts in the law, hospitals will be forced to pare back services or close their doors, industry observers said. ... In response, rural providers have accelerated ongoing operational adjustments, including renegotiating vendor contracts, beefing up their coding and billing processes, freezing new hires and standardizing daily tasks to reduce administrative waste. But those tweaks alone cannot sustain rural hospitals, so some providers are aiming to grow surgeries, infusions and other services to boost their bottom lines, executives said.

Ok, please help calm my anxiety. My mother has drastically improved in the last couple of days since goin on hospice. Aging Care; by Oedgar23; 7/17/25 So in the hospital, my mother was in kidney failure. The last couple days after stopping vancomycin for about five days, her GFR had come up to 19. That’s the most recent Number and then they stopped drawing labs because we placed her on Hospice. We consulted with palliative care team. They wanted to do a feeding tube and we said no. They said she had advanced dementia. [Describes improvements since hospice.] ... What if she gets taken off hospice? ... What if she no longer qualifies for hospice, passes as normal cognitively, starts demanding to go home, does not qualify for long-term care, Medicaid, etc. ... But I am super unnerved because she looks a whole lot better than she has been looking. ...Editor's Note: Yes, we all know that the person can get better with hospice care, because of holistic person-centered care, caregiver education and support, and many more factors. This can be confusing. The dying trajectory may have been interrupted or simply calmed with better symptom management and quality of life. This daughter is asking normal, crucial questions which the hospice team needs to be addressing with her. Examine your live discharge data, Policies and Procedures, communication practices with the patient and family about recertifications, Incident Reports from upset caregivers/families, and CAHPS Hospice scores.

[Norway] iLIVE volunteer study: Volunteer and healthcare professional perceptions of newly developed hospital end-of-life-care volunteer services, in five countriesPalliative Medicine; Tamsin McGlinchey, Stephen Mason, Grethe Skorpen Iversen, Dagny Faksvåg Haugen, Inmaculada Ruiz Torreras, Pilar Barnestein Fonseca, Miša Bakan, Berivan Yildiz, Ruthmarijke Smeding, Anne Goossensen, Agnes van der Heide, John Ellershaw; 5/25Volunteer services that provide direct support to patients receiving palliative and end-of-life care in hospitals are new and developing, but little is known about the use and experience of such services from key stakeholders. 20 Volunteers and 20 healthcare professionals were recruited. Three overall themes were generated: (1) Volunteers provided 'unique, distinct, 'community' support' bringing familiarity to an unfamiliar, medically focussed environment. (2) Volunteers were able to 'establish a connection centred on 'being there' within the acute hospital environment' despite the fast paced and highly changeable environment. (3) Through 'relational interactions adapted to the individual person' volunteers attended to patients' existential and emotional needs. These services confer benefits that are transferrable across cultures and countries, 'fusing' formal care with the informal visiting of family or friends, attending to patients' existential needs.

Agrace opens western Wisconsin office in La Crosse WisBusiness, La Crosse, WI; Press Release; 7/16/25 Agrace continues its rapid growth across the state of Wisconsin with the opening of a new office in La Crosse, a western-Wisconsin city of 52,000 located along the Mississippi River. Since its founding in Madison, Wis., in 1978, Agrace has provided exceptional care for the state’s residents who are in the final months of life. The new Agrace location gives residents of La Crosse County greater choice for high-quality, in-home hospice care. County residents can enroll with Wisconsin’s largest nonprofit hospice to receive hospice care that comes to them where they live—in private homes, long-term care facilities or any other place they call home.

The Alliance’s CaringInfo Program launches new “Planning for In-Home Care” section National Alliance for Care at Home, Alexandria, VA and Washington, DC; Press Release; 7/16/25 CaringInfo.org, a program of the National Alliance for Care at Home (the Alliance), is expanding its resources with a new website section – “Planning for In-Home Care” – as well as a brand refresh to align with its growing audience. CaringInfo provides free resources to educate and empower patients and caregivers to make informed decisions about home, serious illness, and end-of-life care and services. While CaringInfo began with a focus on serious illness and end-of-life care and support, the program’s content is expanding to provide information and resources on the full spectrum of home-based care services. As a first step in this expansion, CaringInfo has launched “Planning for In-Home Care,” a new section on the website focused on the various types of care available at home.