Literature Review

Why home-based healthcare could invite cyberattacks Modern Healthcare, by Diane Eastabrook; 3/29/24 Cybersecurity experts warn that as more healthcare is provided in patients’ homes, the flow of data between those locations, vendors and providers raises the risk for ransomware attacks. In the wake of the Change Healthcare attack, cybersecurity consultants are scrutinizing home-based care — particularly the storage and transfer of data through telehealth, remote patient monitoring and wearable devices. 

Healthcare on the brink: navigating the challenges of an aging society in the United States  npj Aging, by Charles H. Jones and Mikael Dolsten; 4/6/24 The US healthcare system is at a crossroads. With an aging population requiring more care and a strained system facing workforce shortages, capacity issues, and fragmentation, innovative solutions and policy reforms are needed. ... Through a comprehensive analysis of the impact of an aging society, this work highlights the urgency of addressing this issue and the importance of restructuring the healthcare system to be more efficient, equitable, and responsive. 

Insurers’ response to the Change breach failed providers Modern Healthcare, by Chip Kahn and Dr. Bruce Siegel; 4/8/24 ... The Feb. 21 attack on Change Healthcare, a subsidiary of UnitedHealth Group’s Optum unit, severed the electronic ties that connect patients, providers and insurance companies. The attack robbed patients of the certainty they could seek and receive care, and it robbed physicians, pharmacists and hospitals of the resources necessary for patient care. ... Overlooked in this crisis, is that insurance companies failed to act decisively and collectively to protect patients and providers. ... Here’s what should have happened immediately when the threat facing patient care became painfully obvious. 

Medicine—Both a Science (Care) and an Art (CARE) JAMA Network - Viewpoint; by Theodore J. Strange, MD and Mario R. Castellanos, MD; 4/3/24In the current era, health care is increasingly characterized by the integration of big data, predictive analytics, medical devices, and artificial intelligence. These technological advancements have undoubtedly transformed the landscape of medical care, offering unprecedented precision and efficiency in diagnosis and treatment. Yet, amidst this surge of scientific innovation, the timeless art of medicine (compassion and caring) remains a foundational aspect of patient-centered health care ... The acronym CARE (compassion, assistance, respect, and empathy) encapsulates these enduring values. ... In a world increasingly driven by data and algorithms, these qualities foster a trusting and supportive relationship between health care professionals and patients, thereby enhancing the healing process and enriching the overall health care experience.

Navigating new requirements in the 2025 proposed Hospice Rule Hospice News, by Jim Parker; 3/5/24 If the U.S. Centers for Medicare and Medicaid Services’ (CMS) proposed 2025 hospice rule is finalized as written, hospices may encounter some hurdles implementing some of the new requirements. MS late last month issued its proposed hospice rule for 2025. The proposal called for a 2.6% increase in hospice per diem base rates, a number that many stakeholders say is insufficient in today’s economic climate.

It’s past time for an upgrade to the Medicare Hospice BenefitHealth Affairs, by Cara L. Wallace and Stephanie P. Wladkowski; 4/5/24When most people think about hospice care, they imagine someone such as the late Rosalynn Carter, who enrolled onto hospice and died within a few days. Jimmy Carter’s long hospice stay, now more than a year, has shown a different model for hospice—one that supports its mission to help people live well, with dignity and quality of life, for whatever time remains. However, current policy restrictions to enroll and remain on hospice make it difficult for many hospice recipients to receive hospice care for “whatever time remains,” as 17.2 percent of Medicare hospice patients are discharged alive. Editor's Note: Many hospices used Jimmy Carter's one-year anniversary as a marketing tool that hospice is not really for the "dying." Many--if not most--of these articles were not transparent in identifying any type of recertification, decertification, or revocation processes. Yes, while it may be past time for CMS to upgrade the Hospice Benefit, it's also past time for hospice marketing to be more transparent with the public.

Hospice update: March goes out like a lion Morgan Lewis - Health Law Scan, by Howard J. Young; 4/2/24 The old adage—March comes in like a lion and goes out like a lamb—didn’t quite hold true for the hospice sector, which experienced a late-month flurry of activity. The government gave the hospice sector a lot to consider, from MedPAC’s suggested freeze on hospice rates to CMS’s 2025 Proposed Hospice Rule (public comments due May 28, 2024) that, if finalized as is, would include a 2.6% payment bump. CMS’s Proposed Hospice Rule lays the groundwork for the long-anticipated Hospice Outcomes and Patient Evaluation (HOPE) quality measures data collection instrument, which will be used to collect data at various points during the hospice stay, not just at admission and discharge.  

The operational advantages of hiring seniors to provide home care Home Health Care News, by Joyce Famakinwa; 4/1/24Seniors Helping Seniors has long distinguished itself from other home care companies by hiring active seniors to serve as caregivers. Josh Obeiter — an owner of one of the company’s franchise locations — has seen even more added value from this strategy as the industry at large combats labor shortages. At Seniors Helping Seniors, the average age of an employee is around 70 years old, and 80% of caregivers are in their 60s and 70s, according to Obeiter.

Meet the women who give end-of-life care to Utah’s homelessGood Things Utah, by Nicea DeGering; 4/2/24A Utah non-profit’s mission is to provide medical help and end-of-life care to those in our community experiencing homelessness. The Inn Between has been providing unique services in Salt Lake City for eight years.  ... [The] mission of The Inn Between is to end the tragedy of vulnerable people dying on the streets of our community by providing medical respite and end-of-life care to those experiencing homelessness.The group provides a home environment that enables adults experiencing homelessness to gain access to professional hospice care from State-licensed hospice agencies; undergo life-saving medical treatment; stabilize in preparation for surgery; or recuperate from serious illness, injury, or surgery. Editor's Note: Read more to meet Jillian Olmsted, Executive Director and Kellie Mierement, Community Engagement Manager.

The indispensable role of critical thinking in healthcare leadership Forbes, by Dr. Hudson Garret, Jr and the Forbes Business Council; 4/1/24 In the fast-paced and complex landscape of healthcare, where decisions can have life-altering consequences, the value of critical thinking cannot be overstated. Critical thinking is not just a skill; it's a mindset—an essential tool for healthcare leaders to navigate uncertainty, make informed decisions and drive positive outcomes. ... Here are three examples of how I've applied critical thinking in leadership.

Hospice care for those with dementia falls far short of meeting people’s needs at the end of life ArcaMax, Maria J Silveira, University of Michigan; 4/1/24... Strikingly, only 12% of Americans with dementia ever enroll in hospice. Among those who do, one-third are near death. This is in stark contrast to the cancer population: Patients over 60 with cancer enroll in hospice 70% of the time. In my experience caring for dementia patients, the underuse of hospice by dementia patients has more to do with how hospice is structured and paid for in the U.S. than it does patient preference or differences between cancer and dementia.

Northwell backs 'emotionally intelligent' AI voice startupBecker's Health IT, by Gile Bruce; 3/28/24The venture capital arm of New Hyde Park, N.Y.-based Northwell Health is backing a startup that is developing a conversational artificial intelligence platform that mimics human speech. Northwell Holdings participated in a $50 million series B funding round March 27 for Hume AI, which was founded by a former Google researcher to provide "near-human-level conversation" with AI. Northwell has already invested several million dollars in the "emotionally intelligent" voice interface.Editor's Note: Is this an April's Fools Day joke? No. Will these replacements of human conversation improve or potentially harm the patient/caregiver experience? What outcomes could be generated if $50 million was invested in making human professionals more emotionally intelligent? For this high-tech oriented hospice and palliative editor/leader, this direction raises patient/caregiver/professional concerns and cautions. 

[UPDATED] CMS 2025 proposed rule signals changes to quality measurement, omits program integrity actionsHospice News, by Jim Parker; 3/29/24In a proposed rule released [Thursday], the U.S. Centers for Medicare & Medicaid Services (CMS) proposed a 2.6% increase in hospice per diems for 2025. The agency also proposed two new quality measures and 2025 implementation of the Hospice Outcome and Patient Evaluation (HOPE) assessment tool to replace the Hospice Item Set.However, stakeholders in the hospice space contend that the increase is insufficient in light of continued inflation, interest rates, staffing shortages and wage hikes.