Literature Review

National Alliance for Care at Home responds to Kennedy and Dr. Oz announcement on health insurance reform pledgeNational Alliance for Care at Home press release; 6/23/25“The Alliance welcomes today’s announcement made by Secretary Kennedy and CMS Administrator Dr. Oz regarding commitments from major health insurers to streamline prior authorization practices, including implementing enhanced digital interoperability standards and reducing administrative barriers,” said Dr. Steve Landers, CEO for the Alliance. “If these promises are fully kept, this could be a meaningful step toward addressing longstanding barriers that have delayed access to critical care at home for patients who need it.”

A pregnant brain-dead woman in Georgia was kept on life support. Experts say it raises ethical, legal questionsABC News; by Mary Kekatos; 6/19/25Adriana Smith, a brain-dead woman in Georgia, was kept on life support until her fetus was viable. Experts say it raises ethical and legal questions. Adriana Smith, a 31-year-old Georgia nurse and mother, was just eight weeks pregnant when she was declared brain dead in February after suffering a medical condition. However, the family claims the hospital told them legally she had to be kept on life support to allow the fetus to grow. The family claims doctors told them they were not legally allowed to consider other options, according to local Atlanta station 11Alive. Last week, Smith's baby was born by emergency Caesarean section, weighing under 2 pounds and needing care in the neonatal intensive care unit (NICU), reported 11Alive.Publisher's note: This situation raises numerous ethical end-of-life questions - highlighting the importance of hospices having or connecting with local ethics experts.

National Alliance for Care at Home champions bipartisan legislation to transform access to quality in-home skilled nursingNational Alliance for Care at Home press release; by Elyssa Katz; 6/20/25The National Alliance for Care at Home (the Alliance) is pleased to support the introduction of the Continuous Skilled Nursing Quality Improvement Act of 2025. This bipartisan legislation, Senate Bill 1920, introduced by Senator Thom Tillis (R-NC) and Senator Maggie Hassan (D-NH) aims to improve the quality and accessibility of skilled nursing care by modernizing Medicaid’s approach to private duty nursing.

Leading PBMs face increasing scrutiny from statesHealthcare Brew; by Nicole Ortiz; 6/18/25Iowa is the latest to impose limits on how PBMs can operate in the state... It all started when Arkansas Governor Sarah Huckabee Sanders signed a law on April 16 saying any company that owns a pharmacy benefit manager (PBM) would be prohibited from also owning or operating pharmacies in the state. That’s seemingly bad news for the Big 3 PBMs—Cigna Group’s Express Scripts, CVS’s Caremark, and UnitedHealth’s Optum Rx, which collectively control nearly 80% of the market—seeing as they all also operate pharmacy chains. Now the state of Iowa wants to get in on the action, with Governor Kim Reynolds signing a law on June 11 to change how PBMs operate in the state.

Sacred moment experiences among internal medicine physiciansJAMA Network Open; by Jessica Ameling, Nathan Houchens, M. Todd Greene, David Ratz, Martha Quinn, Latoya Kuhn, Sanjay Saint; 5/25Some have described sacred moments as sudden intimacies or moments of deep memorable connection with another person. The health care setting is replete with opportunities for the types of human connections that lead to sacred moments, such as times of crises or grief, or conversely, times of great happiness. These moments leave participants with a sense of joy, peace, and empathy for the others involved. In this survey study of 629 physicians, 68% reported experiencing a sacred moment with a patient, and physicians who considered themselves very spiritual or possessing a strong sense of purpose in life or work had increased odds of experiencing a sacred moment. Both experiencing sacred moments often and discussing them with colleagues were associated with less burnout [and] improve[d] physician well-being.

From burnout to belonging: Creating space for grief in clinical education American Academy of Pediatrics (AAP) Journals Blog; by Rachita Gupta; 6/16/25 ... While significant progress has been made in addressing burnout and emotional distress in medicine, and in incorporating these topics into medical education, many clinicians remain hesitant and uncertain about how to address grief and distress from patient care in day-to-day clinical practice. This uncertainty exists both in terms of their own experiences and, even more so, in supporting trainees. A lack of emotional processing in these difficult situations can accelerate burnout and further disconnect clinicians from the humanism and vulnerability that are intrinsic to the privilege of practicing medicine. ... The recently published Hospital Pediatrics article by Bloomhardt et al, “Good Grief? Introducing the TEARS Framework for Educator to Support Learners Experiencing Grief,” (10.1542/hpeds.2024-008096) addresses the hesitancy many clinicians experience when assessing learners’ emotional processing during or after distressing patient cases by introducing the TEARS framework. ...Editor's Note: See a related post in today's newsletter, "“Her toes fell off into my hand”: 50 moments that changed healthcare workers forever."

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).

[Premier's tonight!] NPHI proud to announce its partnership on the upcoming documentary for PBS, Caregiving, from Executive Producer Bradley Cooper National Partnership for Healthcare and Hospice Innovation (NPHI), Washington, DC; 5/19/25 The National Partnership for Healthcare and Hospice Innovation (NPHI) is proud to announce its partnership on the upcoming PBS documentary Caregiving, a powerful new film executive produced by Academy Award-nominated actor, director, and producer Bradley Cooper. Created in collaboration with Cooper’s production company, Lea Pictures, as well as WETA Washington, D.C., and Ark Media, Caregiving will shine a national spotlight on the often unseen yet essential work of caregivers across the country. NPHI is honored to serve as a national partner on this important project. Narrated by Uzo Aduba (The Residence, Orange Is the New Black) and directed by Chris Durrance, Caregiving intertwines deeply personal stories of caregivers with the untold history of the American care system. The documentary examines how caregivers—often family members, friends, and frontline professionals—navigate the immense challenges and unseen achievements of their roles.

MedPAC Report: Medicare Advantage enrollees receive 11% fewer home health visits Home Health Care News; by Morgan Gonzales; 6/13/25 The Medicare Payment Advisory Commission’s (MedPAC) June report to Congress examined home health care use among Medicare Advantage (MA) and traditional Medicare patients and found that MA enrollees receive 11% fewer home health visits compared to Medicare fee-for-service. ... 

Hospice service to vulnerable people awarded The Chronicle-Journal, Thunderbay, Ontario; by Doug Diaczuk; 6/13/25 An organization that provides palliative care is being recognized for its work at ensuring everyone, including those who may not have a home to call their own, receive the services they need at the end of life. Hospice Northwest [Mount Vernon, WA, USA] is the first recipient of the new Equity in Action Award created earlier this year by Mount Pleasant Group and Hospice Palliative Care Ontario [Canada]. The award is meant to highlight work being done to promote better access to palliative care in communities across the province.

Hospice & Palliative Care Today welcomes our new Guest Editor, Ira Byock, MD, a palliative care physician and emeritus professor of medicine and community & family medicine at Dartmouth's Geisel School of Medicine. Throughout his career he has written about the ethics and practice of caring for seriously ill and dying patients for medical journals. Since the early 1990s, he has contributed op-eds to national newspapers and gradually began writing story-driven books for the general public. His books include Dying Well (1997), The Four Things That Matter Most (2004), and The Best Care Possible (2012). For more, visit IraByock.org. See his post below for "Medicare Home Health Care is the ideal platform for home-based palliative care at the end of life."

How thanatology is driving hospice care innovation Hospice News; by Holly Vossel; 6/13/25 Thanatologists examining dying and grief practices have uncovered significant trends shaping hospice and bereavement care models in recent years. Thanatology is derived from the Greek word for death, “thanatos.” It is commonly described as the study or description of death, dying and loss and the psychological, social, cultural, biological and spiritual aspects of these processes. Editor's Note: A significant addition to this thanatology article for you to know is ADEC, the Association for Death Education and Counseling: The Thanatology Association, at www.adec.org, celebrating its 50th anniversary in 2026. This article describes thanatology as "recent years" and that "several studies have examined examined aspects of the dying process ..." Thanatology--and ADEC's contributions to our end-of-life care field--are much more than "recent," "several studies," and "aspects." ADEC emerged within the same era as Kübler-Ross's first book and the first hospices in the US, years before the Hospice Medicare Benefit. ADEC's thanatology ground-breaking leaders and members include thousands of national and international researchers, editors/authors, academicians, and clinicians throughout the evolution of our end-of-life care field, e.g., William Worden (founding member), Ken Doka (past president), Robert Neimeyer (past president), and so many more. When you see the "FT" or "CT" credential, know that this person has earned the advanced professional credential "Fellow in Thanatology" or "Certified in Thanatology." Recognize the professionals in your organization with these important thanatology credentials. Support your professionals who seek it.

2025 World Hospice and Palliative Care Day: Using the Toolkit Effectively webinar Worldwide Hospice Palliative Care Alliance (WHPCA); press release / email; 6/17/25The Worldwide Hospice Palliative Care Alliance (WHPCA) invites you to attend a 2025 World Hospice and Palliative Care Day: Using the Toolkit Effectively Webinar and you must register in advance, HERE. The theme for WHPCD is Achieving the Promise: Universal Access to Palliative Care, and this year’s World Day will be on 11 October. World Hospice and Palliative Care Day (WHPCD) is a unified day of action in support of hospice and palliative care. Palliative care is an interdisciplinary caregiving approach that optimises quality of life and mitigates health-related suffering among people with very serious illnesses and their carers. WHPCD has been marked every year for the last 19 years.