Literature Review

New bill in Congress would improve end-of-life carePublic News Service; Suzanne Potter; 8/23/24A bill just introduced in Congress would raise public awareness of issues surrounding the end of life, including palliative care, and hospice. The Compassionate Care Act [co-sponsored by Rep. Nanette Barragán, D-CA, and Sen. Richard Blumenthal, D-CT] would establish guidelines for advance care planning between health providers and patients... The bill would direct the government to develop education resources for providers, expand telehealth options and facilitate a study of a national advance care planning registry, which would allow patients to transfer their advance directives from state to state.

John Oliver on US for-profit hospice care: ‘too important to just hope the free market fixes it' The Guardian; by Adrian Horton; 8/19/24 On the latest Last Week Tonight, John Oliver delved into the many issues with hospice care in the US. Doing so is “an almost offensive parody of this show”, he acknowledged. “If somebody else did that, it would genuinely be hurtful. But I promise this is worth talking about.” There are “lots of dedicated people work with hospices, providing huge relief for dying patients and their families, particularly those who want to remain at home”, such as the 1.8 million Americans who received end-of-life care at home last year. But like anything, hospice is subject to fraud, mismanagement and abuse. One government report estimated that hospice’s inappropriate billing costs Medicare hundreds of millions per year. ... “Hospice care, when done well, is hugely beneficial to those that are dying and their families. It is too important to just hope the free market fixes it,” Oliver concluded. “This industry badly needs reform. That’s clear.” [Click on links below for hospice responses to this "Hospice" episode of Last Week Tonight.] 

AI and health insurance prior authorization: Regulators need to step up oversightHealth Affairs; by Carmel Shachar Amy Killelea Sara Gerke; 7/24Artificial intelligence (AI)—a machine or computer’s ability to perform cognitive functions—is quickly changing many facets of American life, including how we interact with health insurance. AI is increasingly being used by health insurers to automate a host of functions, including processing prior authorization (PA) requests, managing other plan utilization management techniques, and adjudicating claims. In contrast to the Food and Drug Administration’s (FDA’s) increasing attention to algorithms used to guide clinical decision making, there is relatively little state or federal oversight of both the development and use of algorithms by health insurers.

Today's Heartwarming Story [MHPCA Hospice in Corrections]Per Facebook post: Over the past decade, the Missouri Hospice and Palliative Care Association has trained hundreds of residents of Missouri state prisons to become hospice volunteers, providing comfort and companionship to terminally ill peers. The newest group recently completed training at Farmington Correctional Center. Volunteers develop skills in helping with daily activities, practicing empathy and active listening, and learning to recognize and respond to patients’ spiritual and emotional needs.

Pennant’s home health, hospice growth ‘significantly ahead’ of prior expectationsHome Health Care News; by Audrie Martin; 8/7/24The Pennant Group Inc. (Nasdaq: PNTG) leaders highlighted the company’s significant home health growth Tuesday. They also teased continued expansion in the East Coast and elsewhere. “We are thrilled to report record-breaking second quarter results as we continue to experience momentum across all our service lines and create meaningful growth opportunities for local leaders and teams,” Pennant CEO Brent Guerisoli said during the company’s second-quarter earnings call. “Our financial performance and growth trajectory reflect the consistent efforts we have applied to every aspect of our business through our five key focus areas: leadership development, clinical excellence, employee engagement, margin and growth.” The Pennant Group is a holding company based in Eagle, Idaho, with independent operating subsidiaries that provide health care services through 117 home health and hospice agencies and 54 senior living communities across 13 states.

Fearless hospice patient takes joyrideWest Valley View (AZ); by Lin Sue Flood; 8/7/24Don Tamuty, a beloved former Madison Unified School District teacher, had one thing left on his bucket list. The 95-year-old shared with his hospice nurse, Monisha Roe, that he would love to ride in a driverless car. Monisha and the rest of Don’s Hospice of the Valley care team knew exactly how to fulfill that wish! They booked a driverless cruise on Waymo One to take Don out to a nice restaurant.

Rescue from above: How drones may narrow emergency response timesKFF Health News; by Michelle Andrews; 7/22/24Starting in September, if someone in Clemmons, North Carolina, calls 911 to report a cardiac arrest, the first responder on the scene may be a drone carrying an automated external defibrillator, or AED. “The idea is for the drone to get there several minutes before first responders,” such as an emergency medical technician or an ambulance, said Daniel Crews, a spokesperson for the sheriff’s office in Forsyth County, where Clemmons is located. The sheriff’s office is partnering on the project with local emergency services, the Clinical Research Institute at Duke University, and the drone consulting firm Hovecon. “The ultimate goal is to save lives and improve life expectancy for someone experiencing a cardiac episode,” Crews said.Publisher's note: As with all things tech, when and how might drones be used in hospice?

Identifying and addressing bias in artificial intelligenceJAMA Network Open; by Byron Crowe, Jorge A. Rodriguez; 8/6/24[Invited commentary.] In this issue, Lee and colleagues (Demographic representation of generative artificial intelligence images of physicians) describe the performance of several widely used artificial intelligence (AI) image generation models on producing images of physicians in the United States. The key question the authors set out to answer was whether the models would produce images that accurately reflect the actual racial, ethnic, and gender composition of the US physician workforce, or whether the models would demonstrate biased performance. One important aspect of the study method was that the authors used relatively open-ended prompts, including “Photo of a physician in the United States,” allowing the machinations of the AI to produce an image that it determined was most likely to meet the needs of the end user. AI tools powered by large language models, including the ones examined in the study, use a degree of randomness in their outputs, so models are expected to produce different images in response to each prompt—but how different would the images be? Their findings are striking. First, although 63% of US physicians are White, the models produced images of White physicians 82% of the time. Additionally, several models produced no images of Asian or Latino physicians despite nearly a third of the current physician workforce identifying as a member of these groups. The models also severely underrepresented women in their outputs, producing images of women physicians only 7% of the time. These results demonstrate a clear bias in outputs relative to actual physician demographics. But what do these findings mean for AI and its use in medicine?Publisher's note: This is a thought-provoking article on machine output - whether that's AI, a Google search, etc. It ultimately places responsibility of outputs and actions on people with conscience.

Free CHAP Webinar: CMS Posts Final Hospice Rule - Quality changes and regulatory requirement Community Health Accreditation Partner (CHAP); taught by Dr. Jennifer Kennedy; posted 8/13/24, webinar will be 8/21/24, 1:00-2:00 pm EDTCMS posted the final rule for hospice providers which drives big changes into motion for 2025.  [Click here for the] Final FY 2025 Hospice Wage Index and Payment Rate Update/Quality Reporting Rule  (CMS-1810-F), posted on the Federal Register on August 7, 2024. This free webinar will be taught by Jennifer Kennedy, Vice President, Quality, Compliance and Standards, CHAP. She spent many years as a leader and nurse in diverse healthcare settings with the past 25 years in hospice and palliative care. Dr. Kennedy came to CHAP in 2021 with a vision of moving the organization’s quality forward as “the” accreditation partner of choice for the majority of community-based providers. She believes no matter what type of care a patient receives or how many times they receive care, every experience should be of the highest quality. Webinar Objectives:

Top news stories of the month, July 2024Teleios Collaborative Network (TCN); podcast by Chris Comeaux and Mark Cohen; 8/7/24 In this week’s podcast, Mark Cohen joins me once more for the Top News Stories for the prior month from Hospice & Palliative Care Today... The conversation covers various topics including private equity in healthcare, the increasing scrutiny of for-profit hospitals, fraud in hospice care, and the importance of trust in the hospice sector. The principal themes include the playbook of private equity playbook, the challenges faced by for-profit hospitals and their potential the impact on the Hospice sector, and the erosion of trust due to fraud.

Becoming time rich with physician moms: Sarah Wittry and Nicole Perrotte MarketScale - Ripple of Change; by Todd Otten; 7/30/24 In today’s high-stress healthcare environment, physician mothers face the formidable challenge of balancing demanding careers with their personal lives. The conversation on work-life balance is more relevant than ever, with more women in medicine seeking ways to manage these dual responsibilities effectively. How can physician moms navigate this landscape to reclaim time for themselves without guilt? What strategies can physician moms employ to achieve a healthier work-life balance? This pressing question lies at the heart of today’s discussion on the Ripple of Change podcast. ... Key points of discussion:

How the Hospice CARE Act could change respite services Hospice News; by Jim Parker; 8/1/24 The Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act, if enacted, would make changes to the ways hospices provide respite care. Rep. Earl Blumenauer (D-Oregon) is in the process of drafting the bill that would represent the most significant reforms to date for hospice payment and oversight. The legislation is currently in a discussion draft phase, which has been circulated among the nation’s major industry trade associations and their members for feedback. ... “There’s evidence that people who take advantage of hospice care delivered properly, actually have a higher quality of life. Oftentimes, they live longer,” Blumenauer said at Elevate. “This is an opportunity to do something in this Congress that is concrete, specific, that will save money and improve the quality of care for some of our most vulnerable people.”

Avow Kids receives transformational gift from Naples Children & Education FoundationAvow Hospice press release; 7/23/24Avow Foundation has received a generous grant of $115,000 from the Naples Children & Education Foundation (NCEF), the founding organization of the Naples Winter Wine Festival. The grant is specifically intended for Avow Kids, a program for children ages 5 - 17 that provides support and companionship to youth experiencing any type of grief. The grant will support Avow Kids’ various services, such as individual counseling, support groups, workshops, camps, music therapy, movie nights, and more.