Literature Review

Trends in private equity acquisition of pain management practicesJAMA Network Open; Geronimo Bejarano, MPH; James E. Eubanks, MD, MS; Robert T. Braun, PhD; 12/24Pain has the highest health care spending in the US and is expected to increase with the aging population, which may entice private equity acquisitions of pain management practices. Private equity has increasingly acquired physician practices and acquisitions are associated with higher spending, utilization of more expensive treatments, and increasing patient volume. In this cross-sectional study of private equity acquisitions of pain management practices, we found a rise in acquisitions over the last decade with almost 1 in 10 pain management physicians affiliated with a private equity–owned pain management practice. [The] ... high amount of consolidation within certain states poses concerns for private equity to have enough market power to control care delivery of several procedure-based specialties, including pain management. Policymakers and the Federal Trade Commission have taken notice of the harms of increases in both health care consolidation and private equity acquisitions, and there are ongoing efforts to curb their detrimental effects. 

Accountable Health Communities (AHC) Model: Third evaluation report (2018-2023)CMS press release; 12/27/24The Accountable Health Communities (AHC) Model tested whether connecting beneficiaries to community resources for their health-related social needs (HRSNs) improved health care utilization outcomes and reduced costs. [The five core HRNS's include housing instability, food insecurity, transportation problems, utility difficulties, and interpersonal violence.] Collectively, these findings provide evidence that navigation can transform the delivery of care in ways that address major HRSN barriers to health and promote health equity for underserved populations.

Health systems are struggling to keep up with AI - A national registration system could helpJAMA; Roy Perlis, MD, MSc; Rita Rubin, MA; 12/24This conversation is part of a series of interviews in which JAMA Network editors and expert guests explore issues surrounding the rapidly evolving intersection of artificial intelligence (AI) and medicine. In a Viewpoint published in JAMA this past August, Michael Pencina, PhD, Duke Health’s chief data scientist, argued for a federated registration system for AI and health. Dr Pencina:I strongly believe that every organization needs to know what AI solutions it has implemented. In particular, health systems should keep track of AI algorithms or other AI solutions they’re running in clinical care and clinical operations. Imagine a portal where you record all the AI that you’re running and all the information related to it. Say Duke does it, but another health system does it, and another health system. It becomes national. That opens really interesting opportunities for collaboration, information sharing, and enhancing the ecosystem, as well as transparency for patients, our ultimate stakeholders.

Recommendations to ensure safety of AI in real-world clinical careJAMA; Dean F. Sittig, PhD; Hardeep Singh, MD, MPH; 11/24As HCOs [health care organizations] adapt their clinical and administrative workflows to new AI [artificial intelligence]-driven technologies, unintended adverse consequences will inevitably occur, particularly during transitions. To address these risks, HCOs and AI/EHR [electronic health record] developers must collaborate to ensure that AI systems are robust, reliable, and transparent. HCOs must proactively develop AI safety assurance programs that leverage shared responsibility principles, implement a multifaceted approach to address AI implementation, monitor AI use, and engage clinicians and patients. Monitoring risks is crucial to maintaining system integrity, prioritizing patient safety, and ensuring data security. 

Hospice volunteering isn't for everyone but a rewarding way to give back News Talk 830 WCCO; by Susie Jones; 12/27/24 Volunteering is big part of the holiday season for some, with people wanting to help others even in difficult times. Being a hospice volunteer isn't for everyone.  It can certainly be scary to sit with someone who is dying. "It's not just a job, it's not just a volunteer gig, and I can always, always welcome new volunteers," says Allina Health hospice program administrator Erika Schuld. However, Schuld says it can be very rewarding. "You're in these really intimate, vulnerable settings, and you just form bonds really quickly, and it really is our honor in hospice to walk along with patients and families," explains Schuld. Doctor Glen Varns is the medical director of the program and he says volunteers do not administer medication. Instead they do other things to support families. Editor's note: The CMS standard 42 CFR §418.78(e) requires hospices to use volunteers for at least 5% of patient care hours. This was waived during the COVID-19 pandemic, and then reinstated May 11, 2023 when the Public Health Emergency (PHE) officially expired. CMS's volunteer requirement is unique to hospice care. Ensure that your hospice provides appropriate selection, background checks, required TB tests, job descriptions for different volunteer roles, matching of the volunteer to the best role, training, supervision, and tracking of hours for CMS's requirement. Additionally, your hospice must adhere to applicable state laws and internal HR Policies and Procedures regarding volunteers. Click here for the CMS standard.

Awards and Recognitions: December 2024

CDC weekly US map: Influenza summary update U.S. Centers for Disease Control and Prevention (CDC) - HHS.gov; retrieved from the internet 1/2/25, with most current data from 12/21/24 A Weekly Influenza Surveillance Report Prepared by the Influenza Division: Outpatient Respiratory Illness Activity Map Determined by Data Reported to ILINet. This system monitors visits for respiratory illness that includes fever plus a cough or sore throat, also referred to as ILI, not laboratory confirmed influenza and may capture patient visits due to other respiratory pathogens that cause similar symptoms. Editor's note: Click here for the map and bookmark it to regularly monitor your service areas through this flu season.

Tributes to President Jimmy Carter

Providence’s joint venture with Compassus likely delayed amid concerns about patient care and rural access Home Health Care News; by Audri Martin; 12/19/24Oregon’s Health Care Market Oversight (HCMO) program is reviewing a proposal to spin off Providence’s home health and hospice services into a joint venture supported by private equity. ... OHA’s HCMO program evaluates health care business transactions to ensure they do not negatively impact citizens or communities. The program also empowers state regulators to impose conditions on acquisitions and mergers or reject deals they find anti-competitive. Critics of the deal argue that the joint venture will result in cost-cutting measures, increased staff workloads and reduced patient services. Providence is the fifth largest nonprofit health care provider in the United States, while Compassus is a private equity-backed provider of home-based care services operating in more than 30 states.

Hospice Special Focus Program ListCMS Announcement; 12/20/24December 20, 2024: Today, the Centers for Medicare & Medicaid Services (CMS) released the list of the initial cohort of 50 hospices selected for participation in the Hospice Special Focus Program (SFP) in 2025. The SFP program, led by the Center for Clinical Standards and Quality, drives hospice quality improvement through increased health and safety oversight. This effort is a continuation of CMS’s commitment to improving hospice care for patients and families by holding hospice agencies accountable to national health and safety standards. [The initial cohort of 50 hospices selected for participation in the SFP can be downloaded here.]

Muslim community-engaged research highlights Muslim Americans' end-of-life-healthcare gaps and needs WisconsinMuslimJournal.org; by Sandra Whitehead; 12/20/24 Few Muslim Americans use hospice care, despite its posited benefits. A multi-sectoral team of academicians and community leaders in southeastern Wisconsin decided to find out why. ... Muslims are one of the fastest-growing religious communities in the United States, numbering between 3 to 5 million, with projections it will double by 2050. “With an aging Muslim population, there is a growing need for specialized healthcare services like hospice and palliative care,” the team’s research explains. ... Through a qualitative descriptive study with a Muslim patient and 10 family caregivers, the research team identified their perceptions of hospice care, ethical concerns and experiences. Among their varied perceptions, many saw it as useful only in the last hours of life. Participants also had ethical concerns about the use of sedative medication and with cessation of feeding terminally ill patients. Some had concerns about how hospice care might lead to unnecessary interventions or even hasten death. ...  The team is developing an informational resource, Islamic Bioethical Considerations for the End of Life: A Guide for Muslim Americans, to help Muslims who struggle when thinking about death and dying. 

Mobile app–facilitated collaborative palliative care intervention for critically ill older adults-A randomized clinical trialJAMA Internal Medicine; Christopher E. Cox, MD, MPH; Deepshikha C. Ashana, MD, MBA, MS; Katelyn Dempsey, MPH; Maren K. Olsen, PhD; Alice Parish, MSPH; David Casarett, MD; Kimberly S. Johnson, MD; Krista L. Haines, DO; Colleen Naglee, MD; Jason N. Katz, MD, MHS; Mashael Al-Hegelan, MD, MBA; Isaretta L. Riley, MD, MPH; Sharron L. Docherty, RN, PNP, PhD; 12/24An automated electronic health record–integrated, mobile application–based communication platform that displayed family-reported needs over 7 days, coached ICU attending physicians on addressing needs, and prompted palliative care consultation if needs were not reduced within 3 study days. In this randomized clinical trial, a collaborative, person-centered, ICU-based palliative care intervention had no effect on palliative care needs or psychological distress compared to usual care despite a higher frequency of palliative care consultations and family meetings among intervention participants.

ProCare Hospice of Nevada names nationally recognized hospice expert Keith Everett as new CEOProCare Hospice press release; 12/9/24In a move that underscores its vision to transform the cultural perceptions of advanced illness care, ProCare Hospice of Nevada (PCH) proudly announces Keith Everett as its new Chief Executive Officer. Everett, a proven leader in hospice care, most recently served as the President and CEO of Hospice of Acadiana in Lafayette, Louisiana.