Literature Review

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. 

Pain Management at the End of LifeJournal of Hospice and Palliative Nursing; HPNA position statement; 8/24Pain management is essential from the time of diagnosis of a serious illness and throughout the disease trajectory. Unfortunately, the prevalence of pain in those with serious illness remains unacceptably high. In most cases, pain experienced by people with advanced disease can be prevented or relieved through optimal care, yet studies reveal that patients continue to experience uncontrolled pain in the final weeks, days, and hours of their lives...

What drives health spending in the U.S. compared to other countries?Peterson-KFF Health System Tracker; By Emma Wager Twitter, Shameek Rakshit, Cynthia Cox; 8/2/24The United States spends significantly more on healthcare than comparable countries do, and yet has worse health outcomes. Much of the national conversation has focused on spending on retail prescription drugs and insurer profits and administrative costs as key drivers of health spending in the United States. The Inflation Reduction Act, signed into law by President Biden in 2022, includes several provisions aimed at lowering the cost of these prescription drugs. While it is true that many brand-name retail prescription drugs are priced higher in the U.S. than in peer countries, health spending data indicates that other spending categories – particularly hospital and physician payments – are primary drivers of the U.S.’s higher health spending. This brief examines the drivers of health spending and differences between the U.S. and its peers – other Organisation for Economic Co-operation and Development (OECD) nations that are similarly large and wealthy. In 2021, the U.S. spent nearly twice as much per capita on health as these comparable countries did. Most of the additional dollars the U.S. spends on health go to providers for inpatient and outpatient care. The U.S. also spends more on administrative costs, and significantly less on long-term care. [Long-term care spending includes health and social services provided in long-term care institutions such as nursing homes as well as home- and community-based settings.] ... In 2021, the U.S. spent nearly twice as much on health per person as comparable countries ($12,197 compared to $6,514 per person, on average).

What’s changed in hospice in 2024?Managed Healthcare Executive; By Deborah Abrams Kaplan; 8/5/24Hospice use continues to grow as more older people have serious diseases, leading to the need for more palliative care. At the same time, CMS is adapting and trying new models to measure and improve quality and pay for services. The federal government spent $23.7 billion on hospice care in 2022, according to the latest Medicare Payment Advisory Commission (MedPAC) report, with at least 1.7 million Medicare beneficiaries receiving service. This includes nearly half of Medicare beneficiaries who died that year. Here’s what to expect over the next year. [Summarized]

Hospices build community partnerships to better serve patients, employees Hospice News; by Jim Parker; 7/29/24 Hospice care does not occur in a vacuum, and many operators find themselves building partnerships with other community organizations to better serve patients and support their staff. Providers work with other institutions to provide general inpatient and respite care, address social determinants of health and improve health equity, among other initiatives. Some also partner with medical and nursing schools to ensure students in health care fields gain exposure to hospice and palliative care principles. Notable Mentions: Skelly Wingard, CEO of By the Bay Health; Mary Shankster, Chief Development Officer at Stillwater Hospice; Altonia Garrett, COO of Blue Ridge Hospice

Acupuncture as a support in palliative care at Sun City Center HAW The Tidewater News, Ruskin, FL; 7/22/24 Sun City Center Health and Wellness (HAW) is dedicated to providing comprehensive care for patients managing serious illnesses, championing the use of acupuncture as a key supportive treatment in palliative care. This practice, grounded in traditional Chinese medicine, offers relief from common symptoms and enhances overall well-being. ... The role of acupuncture in palliative care is gaining recognition for its potential to improve the quality of life for patients dealing with serious illnesses.

Hospices strategize sustainable growth for Veteran Programs Hospice News; by Holly Vossel; 7/26/24 Hospices combat both operational and financial challenges as they seek to grow and evolve their veteran programs around the diverse and complex needs of patients and their families. Some of the largest expenses associated with offering veteran services include staffing and training costs ... In addition to staff training, this includes having ways to honor veterans for their service, assess the social determinant of health resources they may need and identify gaps of caregiver support. ... Forming community collaborations with organizations such as We Honor Veterans [NHPCO], Wounded Warriors or the Veteran Affairs’ (VA) Pet Partners therapy program can be beneficial to having a more inclusive care delivery approach.Editor's Note: Notable mentions include Carlos Graveran, executive director at Maryland-based Frederick Health Hospice; Sherri Bickley, vice president of patient support services at Oklahoma-based Crossroads Hospice & Palliative Care; and Carla Creegan, PACE director of clinical services and director of adult day swervices at Empath Health.

Senators introduce bipartisan bill to expand access to senior care program [PACE] FCFreePress.com; by News Desk - Health News; 7/25/24 [Thursday, 7/25/24,] U.S. Senators Bob Casey (D-PA) and Mike Braun (R-IN), leaders of the U.S. Senate Special Committee on Aging, introduced the bipartisan PACE Anytime Act. This legislative move seeks to broaden the accessibility of the Program of All-Inclusive Care for the Elderly (PACE) which serves thousands of lower-income seniors and individuals with disabilities by offering comprehensive, integrated care. ... Under current regulations, eligible individuals can only enroll in PACE programs at the beginning of each month. The PACE Anytime Act proposes to remove this restriction, allowing for enrollment at any time during the month, thereby making the program more accessible. 

Empath Health, Trustbridge leaders are setting home health sights high after integration Home Health Care News; by Joyce Famakinwa; 7/26/24 Empath Health is a company in transition. In the spring, it completed an affiliation process with Trustbridge, which formed the largest nonprofit post-acute provider organization in the state of Florida. ... Since completion of the affiliation process, the company has focused on integration, synergistic opportunities and determining how best to deliver care to the communities it serves. One of the people at the helm of this transition is Tarrah Lowry, Empath Health’s chief operating officer and Trustbridge’s interim president. [Click on the title's link to read the recent interview by Home Health Care News' with Tarrah Lowry.]

‘Green burials’ grow in popularity as alternatives to traditional funerals Planet Detroit; by Erica Hobbs; 7/24/24|... [Modern] funeral practices are wreaking havoc on the environment. Bodies are embalmed with toxic chemicals and buried in caskets placed in non-biodegradable vaults that take up increasingly limited space in cemeteries. According to a Cornell University study, an estimated 4.3 million gallons of embalming fluid, 20 million feet of hardwood, 1.6 million tons of concrete and 64,500 tons of steel are used in American burials yearly. Even cremation — often thought of as a green alternative to burial — requires up to 500 gallons of fuel and releases up to 250 pounds of carbon dioxide emissions, according to a recent study from the Green Burial Council (GBC). However, for those looking to reduce their carbon footprints even in death, green options, though still relatively rare, are available in Michigan. ... [Click on the title's link to continue reading these descriptions of "green burials."]

[CMS Fact Sheet] Fiscal Year (FY) 2025 Hospice Payment Rate Update Final Rule (CMS-1810-F) CMS Fact Sheet - Final Rule (CMS-1810-F); 7/30/24 On July 30, 2024, the Centers for Medicare & Medicaid Services (CMS) issued a final rule (CMS-1810-F) updating Medicare hospice payment rates and the aggregate cap amount, for fiscal year (FY) 2025, in accordance with existing statutory and regulatory requirements. This rule also finalizes the proposal to adopt the most recent Office of Management and Budget (OMB) statistical area delineations, which impacts the hospice wage index and clarifies current policy related to the hospice “election statement” and the “notice of election” (NOE), as well as adds clarifying language regarding hospice admission and certification of terminal illness. The final rule summarizes public comments received related to the request for information regarding implementing a separate payment mechanism to account for high-intensity palliative care services. Editor's Note: Click here for the full Final Rule.