Literature Review

Why California doesn't know how many people are dying while homelessKQED, by Vanessa Rancano; 3/25/24 The grants manager and his team at Alameda County Health Care for the Homeless knew people were dying on the streets, but they wanted more than anecdotal evidence; they wanted data that could show them the big picture and help them hone their strategies. ... Alameda County’s latest homeless mortality report is now prompting the team to focus on how to extend palliative care services to unhoused people with terminal illnesses. Garlin estimates almost one-fifth of those who died in 2022 would likely have been eligible for hospice care.

Medicaid Health Plan will reimburse Health Equity Certification HealthPayerIntelligence, by Kelsey Waddill; 3/22/24 Meridian Health Plan of Illinois, Inc.—a wholly-owned subsidiary of Centene Corporation that offers Medicaid coverage—announced that it will cover part of the fee hospitals must pay to undergo health equity certification through the Joint Commission. ... The health plan’s goal in offering this aid is to support providers’ efforts to reduce local care disparities.

Massachusetts makes paid family leave more accessible, offering services in Spanish, Portuguese New England Public Media, by Elizabeth Roman; 3/22/24... The state passed a law in 2018 which provides paid family and medical leave (PFML) for serious injury or illness whether personal or a family member, as well as time for parental leave, but found that people whose primary language is not English were unaware of, or hesitant, to apply for the services. ... While the state portal for applying for PFML services now has options in various languages, some people are still overwhelmed by filling paperwork out online. ... There are representatives who speak Spanish and Portuguese and the state also works with an interpretation service for many other languages.

HHS Secretary Becerra: We’re with you on telehealth flexibilities Hospice News, by Jim Parker; 3/21/24 Telehealth flexibilities must become permanent U.S. Health and Human Services (HHS) Secretary Xavier Becerra indicated in a congressional hearing [Wed]. At the end of this year, telehealth flexibilities implemented during the pandemic are slated to expire. In a hearing before the U.S. House Ways and Means Committee Becerra said that HHS was willing to make them permanent. However, he said this would require closer collaboration with state governments. “We’re with you. We can’t allow those flexibilities to expire, and we need to work closer with our state partners, because much of the flexibility that comes from telehealth means being able to go over state lines,” Becerra said.

5 myths about dying that too many people believeThe Hearty Soul, by Maria Sykes; 3/21/24 Myth# 1: I should always stay positive for the sake of my loved one.Myth #2: I should make sure my loved one eats, drinks, and sleeps as normal.Myth #3: I need to prolong my loved one's life as much as possible.Myth #4: It's important to limit the use of painkillers to keep my loved one healthy.Myth #5: If I seek help to care for my loved one, I'm a failure. 

Home-based care employment exceeding pre-pandemic levels Hospice News, by Jim Parker; 3/19/24 Employment in the home-based care sector rose above pre-pandemic levels in 2023, according to the Medicare Payment Advisory Commission (MedPAC). The U.S. Department of Commerce defines this sector to include hospices, home health agencies, private duty, pediatric agencies and other providers of care in the home. ... Nevertheless, workforce pressures and associated costs are overwhelmingly the industry’s most damaging headwind, including the associated wage hikes, enhanced benefits and bonus programs. The shortages also have reduced clinical capacity, which has contributed to drops in patient census and length of stay for many providers.

Medicare Advantage prior authorization: The impact - increased access to care HHS-OIG; 3/19/24 HHS-OIG’s work on this issue drew national attention to the problem spurring the Centers for Medicare & Medicaid Services, the Industry, and Congress to action.  Editor's Note: You can download the "Impact Brief" from this site. Click on the title's link.

Use of machine learning to optimize referral for early palliative care: Are prognostic predictions enough  Journal of Clinical Oncology - Editorials; by Gary E. Weissman, MD, MSHP; Joseph A. Greer, PhD; and Jennifer S. Temel, MD; 3/15/24  The Takeaway In the article that accompanies this editorial, [Weissman] et al used a machine learning (ML) algorithm to identify patients with advanced cancer who were receiving non–curative-intent treatment and at risk of death within 1 year to allocate early palliative care services at least 6 months before death as a means to increase use of early palliative care in the context of limited resources. While ML prognostic models are one promising strategy for triaging palliative care services, initiation of palliative care based exclusively on estimated survival and in the months before death likely excludes patients who would benefit from early palliative care initiated at the time of diagnosis, regardless of their estimated survival.

Institutional effforts to address legacies of slavery—Implications for the health care system JAMA Health Forum; by Sara N. Bleich, PhD; Jose F. Figueroa, MD, MPH; Martha Minow, JD; 3/14/24... Health care systems across the country are increasing their efforts to help address structural racism. For example, the Healthcare Anchor Network (HAN), which launched in 2017, includes 40 health systems in 45 states and Washington, DC, that have committed to address structural racism and the corresponding public health disparities. HAN aims to improve community health by leveraging key assets such as hiring, purchasing, and place-based investment strategies.

Palliative and end-of-life care in hematologic malignancies: Progress and opportunities JCO Oncology Practice, by Mazie Tsang, MD, MAS, MS and Thomas W. LeBlanc, MD, MA, MHS, FAAHPM, FASC; 3/13/24 ... An important finding from this study was the qualitative data from narratives of volunteer caregivers and hospice staff that described daily patient care, changes in patient status, perceived symptom burden, and indications for medication administration. The authors identified skin integrity concerns, bleeding, pathologic fractures, and delirium as unique issues for patients with hematologic malignancies enrolled on hospice. ... These findings provide further evidence that hospice care can and does work well for some patients with hematologic malignancies. 

Film Festival and local organizations partner to present ‘Lily’ March 21 Sedona.Biz; 3/9/24Accord Hospice & Palliative Care is continuing their educational efforts by partnering with the Hospice Foundation of America (HFA) to marry theater and Advance Care Directive education through the AD Project – a series of 10-minute plays that feature different relationships and settings to illustrate the importance of putting your medical wishes in writing. ...Playwright Bryan Harnetiaux has worked with HFA for years developing a series of shows that depict real life scenarios involving all different family dynamics. The show “Lily” will present a divorced couple who are embarking on a very real dilemma – who to choose to be your voice when you can no longer speak for yourself.

Death Cafes in Duluth aim to make end of life something more normal to talk about ABC WDIO; 3/11/24 Talking about death can be difficult and daunting. A Duluth woman who’s an estate attorney wants to change that. Amy Kuronen just hosted her first Death Cafe. Nine people attended, and it was an open ended conversation without an agenda. ... It’s not a grief support group, although you can mention your grief. It’s more about connecting and sharing. Editor's Note: Are you aware of Death Cafes in your area? Do their representatives have relevant information about your hospice and palliative care services?

Oncology hospitalists improve hospice transitions for patients with advanced cancers Yale School of Medicine, by Osman Moneer; 3/11/24Unplanned hospitalizations for patients with advanced cancer often trigger discussions about care goals and transitions to hospice. Late referrals to hospice, particularly near the end of life, have been associated with reduced quality of life and increased healthcare costs. A new research study published in Cancer investigates the impact of oncology hospitalists on the timing of hospice transitions for patients with advanced cancers.