Literature Review

Hospice advocate Judi Lund Person ... featured on Close Up Radio Western Slope Now, Ashburn, VA; by EIN Presswire; 7/26/24 (article) and 7/29/24 (recording)... Talking about where you’d like to be, who you’d like to be, and what you’d like to do is essential to entering this life-stage with confidence and grace. As the former Vice President of Regulatory and Compliance at the National Hospice and Palliative Care Organization (NHPCO) and a longtime advocate for hospice services under Medicare, Judi Lund Person has been working hard for more than 40 years to protect the definition of hospice care and to provide resources and guides for hospice providers to meet the Medicare requirements and provide high quality hospice care. ... Her passion for supporting patients and families during and after death began as a child. “When I was 12, my dad had a heart attack at night and passed when he was only 42. With two younger sisters, ages eight and ten, I was stunned that no one seemed to know what to do with us concerning our grief as children. We were left to try and figure it out on our own. I always thought that wasn’t quite right. Deep down, that experience was a driver for my career. I always knew families deserved more support during the grieving process,” shares Ms. Person. Editor's Note: Click here for the session's description. Click here for the recording. 

Home health sees spending, utilization decline as hospice equivalents grow, MedPAC reportsMcKnight's Home Care; by Adam Healy; 7/19/24Though hospice spending and utilization appear to be on the rise, Medicare spending on home health has fallen amid declining utilization in recent years, according to a new report by the Medicare Payment Advisory Commission. In 2022, the year of the most recent available data, Medicare home health spending shrank to $16.4 billion. That compares to $17 billion the year prior, the report found. Meanwhile, the number of home health users declined by 6.3% from 2021, and the overall share of Medicare beneficiaries that use home health shrank by 3% from the year prior. The total number of in-person home health visits decreased by 9.6% year-over-year in 2022... Meanwhile, the hospice industry has experienced both reimbursement and utilization gains in recent years, MedPAC reported. Medicare hospice payments rose 2.7% year-over-year in 2022, while the number of beneficiaries using hospice services ticked up by 0.4%. These patients are also receiving more care; the total number of hospice days provided to beneficiaries increased by 2% in 2022.

Help improve the PEPPER ProgramPEPPER email; 7/30/24There is a temporary pause in distributing Program for Evaluating Payment Patterns Electronic Reports (PEPPERs) as the Centers for Medicare & Medicaid Services (CMS) work to improve and update the program and reporting system. This pause will remain in effect through the fall of 2024. We recognize the importance of these reports to your practice. Therefore, during this time, CMS will be working diligently to enhance the quality and accessibility of the reports. In fulfilling this commitment, CMS seeks responses to a series of questions listed in the Request for Information (RFI). These questions will provide CMS with information that may be used to reevaluate PEPPERs and improve the effectiveness and accessibility of the program. The RFI (PDF) is available here. Responses are due on or before 08/19/2024 and must be provided via online submission at the following address: CBRPEPPERInquiries@cms.hhs.gov. 

HHS unveils major revamp to shift health data, AI strategy and policy under ONC Fierce Healthcare; by Emma Beavins; 7/25/24 The Office of the National Coordinator for Health Information Technology (ONC) has been renamed and restructured, the Department of Health and Human Services (HHS) announced [July 25]. The restructuring will affect technology, cybersecurity, data and artificial intelligence strategy and policy functions. The agency will be renamed the Office of the Assistant Secretary for Technology Policy and Office of the National Coordinator for Health Information Technology (ASTP/ONC). Head of ONC, Micky Tripathi, will hold the new title of assistant secretary for technology policy in addition to his title of national coordinator for health IT. ... Under ASTP, there will be an Office of Policy, an Office of Technology, an Office of Standards, Certification and Analysis and an Office of the Chief Operating Officer. 

New proposed federal legislation takes aim at concerns regarding perceived “looting” of health care systems by private equity investors JDSupra - Epstein Becker Green; by Melissa Jampol, Enrique Miranda, Kathleen Premo; 7/26/24On June 11, 2024, U.S. Senators Ed Markey and Elizabeth Warren from Massachusetts, introduced proposed legislation titled The Corporate Crimes Against Health Care Act (“CCAHCA”), aimed at addressing a perceived “looting” of health care systems by for profit private equity investors. According to Sen. Warren, the bill was introduced to “root out corporate greed and private equity abuse in the health care system,” “prevent exploitative private equity practices,” and to specifically ensure that actions such as “looting” do not happen again by addressing trigger events and targeting real estate investment trusts. ... Finally, the CCAHCA would require health care entities, including, but not limited to:  ... a hospice program, a home health agency, ... to publicly report to the Secretary of Health and Human Services on an annual basis: (i) transactions entered into ... [Click on the title's link to continue reading.]

How Medicare Advantage, traditional Medicare differ on end-of-life care Becker's Payer Issues; by Rylee Wilson; 7/24/24 Medicare Advantage enrollees were less likely to receive burdensome treatments or transfers in the last months of life compared to their peers in traditional Medicare, a study published July 19 in JAMA Health Forum found. MA beneficiaries were less likely to die in a hospital than their counterparts in traditional Medicare, the study found. MA enrollees were more likely to receive home-based care at the end-of-life. This home-based care can improve quality but can also leave patients without adequate assistance after a hospitalization, the study's authors wrote. Though Medicare Advantage beneficiaries were less likely to be hospitalized during the last months of life than their counterparts in traditional Medicare, once hospitalized, MA enrollees were more likely to die in the hospital and less likely to be discharged to rehabilitative or skilled nursing facilities. 

Youngstown hospice nurses help alert feds on alleged insurance fraud; company pays settlementMahoning Matters; by Erina Anwar; 7/26/24 ... The U.S. Department of Justice announced on July 17 that federal prosecutors had settled with Gentiva, formerly known as Kindred at Home, after more than 20 whistleblowers — including two hospice nurses from Youngstown, Ohio — alerted the government for alleged fraud. The [Youngstown] nurses, Jason Medved and Anthony Donnadio, will receive a portion of the payout for reporting the fraud at a Youngstown hospice via a lawsuit they filed in 2023 under the federal False Claims Act (FCA). “As registered nurses, Jason and Anthony owed a duty to their hospice patients first and foremost,” Janel Quinn, a principal of The Employment Law Group said. “They were advocates for ethical medicine, even when it wasn’t easy. This settlement is a fitting recognition of their professionalism and their bravery.”

Medicare physician pay has plummeted since 2001. Find out why. American Medical Association - AMA; by Tanya Albert Henry; 7/17/24 Medicare physician payment—often called Medicare reimbursement—must be tied to an inflation index called the Medicare Economic Index (MEI). As part of its campaign to fix the unsustainable Medicare pay system, the AMA has outlined in a quick, easily navigable fashion why this payment fix needs to happen now. ... The AMA’s two-page explainer on the Medicare Economic Index (PDF) outlines how it incorporates these two categories reflecting the resources used in medical practices:

These are the most common jobs in each state in the US USA Today; by Sara Chernikoff; 7/22/24 The most common job in the U.S. is a three-way tie, according to data from the Bureau of Labor Statistics. Home health care and personal aides, retail workers and fast food counter workers ranked at the top of the list with 3.6 million workers in each occupation. ... The desire for home health and personal care aides is on the rise as the share of the elderly U.S. population grows exponentially. This occupation is the fastest growing among most states, news outlet Stacker, reported. ... Home health care aides typically assist people living with disabilities or with chronic illness. Personal care aides are often hired to care for people in hospice care, according to BLS. Advanced degrees are not required for most home health aides, rather those employed by home health or hospice agencies may need to complete formal training or pass a standardized test.Editor's Note: Federal requirements for nursing aides in hospice care are defined in the CMS Hospice of Conditions Participation §418.76 and for home health in the CMS Home Health Conditions of Participation §484.80. Additionally, extensive state laws exist, with differences between states.

How well does Medicare cover end-of-life care? It depends on what type Medical Xpress; by Mark Harden, CU Anschutz Medical Campus; 7/19/24 Not all versions of Medicare are created equal—and when it comes to end-of-life care, some versions may serve a patient's needs better than others. That's the focus of newly published research by Lauren Hersch Nicholas, Ph.D., MPP, a University of Colorado Department of Medicine and CU Cancer Center health economist, and her colleagues. The researchers analyzed the experiences of more than a million people receiving Medicare-funded services in the last six months of their lives. ... Their paper was published July 19 in JAMA Health Forum. What Nicholas and her colleagues found is that the kind of Medicare a patient is enrolled in can make a difference in whether that patient gets certain treatments, and whether the patient dies in a hospital or in hospice care.

Does Medicare pay for dementia care? Here’s what coverage you can expect for treatments and therapies Aol - Fortune; by Margie Zable Fisher; 7/18/24 Age-related memory loss is common, but more serious memory problems may be a sign of dementia, which is not a normal part of aging. ... Dementia patients have a variety of medical issues. “In addition to symptoms related to dementia, the overwhelming majority of dementia patients have one or more chronic health conditions,” says Matthew Baumgart, Vice President of Health Policy, at the Alzheimer's Association. Medicare (and Medicare Advantage) provide some coverage for dementia, beginning with the diagnosis, says Baumgart. [Click on the title's link for practical, user-friendly information about what Medicare provides arose the trajectory of dementia's progression. CMS's new GUIDE pilot program is described.]

Caring with compassion: VNA Health’s commitment to holistic home health care VNA Health Live Well; by VNA Health; 7/10/24 Santa Barbara County has a unique home health care organization that is focused on serving its patients and their families without worrying about turning a profit. “As a nonprofit, VNA Health is more invested in the overall care of the patient,” said registered nurse Jadona Collier, the director of home health. “We provide programs and services that cannot be billed to Medicare or insurance.” The organization offers holistic care, meaning that, regardless of the service being used — including home health care, palliative care, hospice, and bereavement care — its medical professionals care about patients.