Literature Review

Alliance Member, Jonathan Fleece, testifies before Congress on the value of care at home National Alliance for Care at Home, Washington, DC and Alexandria, VA; Press Release; 3/11/25 The National Alliance for Care at Home (the Alliance) released the following statement at the conclusion of a hearing conducted by the House Ways & Means Subcommittee on Health on After the Hospital: Ensuring Access to Quality Post-Acute Care:"The Alliance thanks Chairman Vern Buchanan (R-FL), Ranking Member Lloyd Doggett (D-TX), and all members of the Health Subcommittee for convening this important discussion on post-acute care,” said Dr. Steve Landers, CEO of the Alliance. “This hearing provided an opportunity to amplify the voices of home health and hospice providers and reinforce the essential role they play in delivering high-quality, patient-centered care in the setting people prefer—at home. “We are especially grateful to Jonathan Fleece, CEO of Empath Health, for sharing his expertise and for his service on behalf of patients and families. ... As our nation’s population rapidly ages, it is more critical than ever to get these policies right and ensure that home health and hospice remain accessible and protected from harmful cuts and unnecessary administrative burdens. ..." [Click on the link's title for more, including the full committee hearing testimony.]

Hospice care quality: Latest CMS data Becker's Hospital Review; by Elizabeth Gregerson; 3/12/25 CMS has analyzed data from more than 5,000 hospice agencies for its latest update to Care Compare. Care Compare, a consumer search tool for home health, hospice and other Medicare-reimbursed healthcare services, provides patients with information to make informed decisions about healthcare. National hospice care quality data from April 1, 2023, and March 31, 2024, was published by the agency Feb. 19. ... The proportion of hospice patients who received each care measure:

What happens to care when private equity firms buy hospice providers? KALW Public Media / 91.7 FM, Bay Area, CA; by Rose Aguilar and Nina Kissinger; 3/12/25 On this edition of Your Call, we discuss the rise of for-profit hospice agencies in the US and how that's affecting care. Between 2015 and 2022, 47 private equity firms bought 124 hospice providers. Though hospice began as a nonprofit, community-based service in the 1970s to provide specialized end-of-life care, over 70 percent of hospice providers are now for-profit, according to the CDC. What’s behind this alarming trend? And how is it affecting patient care and the right to transition with dignity?  uests: Dr. Ira Byock, palliative care physician, public advocate, founder of the Institute for Human Caring and Jennifer Moore Ballentine, CEO of the Coalition for Compassionate Care of California.

Empath Health CEO to Congress: Invest in home-based care Hospice News; by Jim Parker; 3/11/25The federal government must invest further in home-based care, Empath Health CEO Jonathan Fleece told lawmakers at a hearing with the U.S. House of Representatives Ways & Means Health Subcommittee. leece was among several post-acute care leaders who appeared at the hearing, representing home health, hospice, skilled nursing facilities, rehabilitation hospitals and other stakeholders. In opening remarks, Fleece pointed to the benefits of home-based care for patients and families, as well as the sector’s ability to reduce health care costs. 

748 hospitals at risk of closure, state by state Becker's Hospital CFO Report; by Molly Gamble; 3/6/25 Nearly 750 rural U.S. hospitals are at risk of closure due to financial problems, with nearly half of those hospitals at immediate risk of closure. The count of 748 at-risk rural hospitals comes from the latest analysis from the Center for Healthcare Quality and Payment Reform, which is based on CMS' most recent hospital financial information. The center's analysis reveals two distinct levels of vulnerability among rural healthcare facilities: risk of closure and immediate risk of closure. In the first category, nearly every state has hospitals at risk of closure, measured by financial reserves that can cover losses on patient services for only six to seven years. In over half the states, 25% or more of rural hospitals face this risk, with 11 states having a majority of their rural hospitals in jeopardy. [Click on the title's link for the list.]Editor's note: On July 5, 2024, we posted from the same source (Becker's Hospital CFO Report) that "Since January 2005, 192 rural hospitals have closed or converted ... Of those hospitals, 105 have completely closed, and 87 have converted, meaning the facilities no longer provide inpatient services, but continue to provide some services, such as primary care, skilled nursing care or long-term care. Since 2020, 36 hospitals have closed or converted. Find the list here. This jump in number is both dramatic and traumatic for our rural communities.

Can default palliative care referrals increase consults? Medscape; edited by Gargi Mukherjee; 3/4/25 A default palliative care referral intervention increased palliative care consultations by more than fivefold and decreased end-of-life systemic therapy by more than half among patients with advanced cancer being treated in the community oncology setting. ...

Challenges to video visits for patients with non–English language preference-A qualitative studyJAMA Network Open; Marianna Kong, MD; Francine Rios-Fetchko, BA; Madelyn Olmos-Rodriguez, BA; Linda Branagan, PhD; Bradley Iott, MPH, MS, PhD; Therese Chan Tack, DO, MPH; Carol Yarbrough, MBA; Kevin Grumbach, MD; Alicia Fernandez, MD; 2/25Telemedicine, or synchronous video or audio-only visits, has made clinical encounters more convenient and accessible for many patients. Prior to the COVID-19 pandemic, video and telephone visits comprised a small minority of primary care visits, but by April 2020, approximately one-half of US physicians were treating patients virtually and nonurgent telemedicine video visits increased by more than 600%. In this qualitative study, participants with NELP [non-English language preference] perceived multiple barriers to video visits, including greater communication difficulties, lower medical evaluation quality, and technical issues. These findings suggest that addressable technical challenges associated with language barriers hamper access to video visits and decrease motivation for use and that interventions are needed to increase telehealth equity. 

Armed 60-year-old man arrested, accused of shooting at hospice nurse in Orange County ABC News 12, Vidor, TX; by Scott Eslinger; 2/28/25 A 60-year-old Vidor man was arrested after a hospice nurse accused of him of shooting at her outside a patient's home. Gordon Billy Ward, 60, of Vidor, was arrested on Thursday by Orange County [California] deputies and booked into the Orange County jail. He is currently being held there on a charge of aggravated assault with a deadly weapon, according to jail records. [Click here for the related California post.]

The Alliance commends introduction of legislation to extend hospice telehealth flexibilities  National Alliance for Care at Home, Alexandria, VA and Washington, DC; Press Release; 2/28/25 The National Alliance for Care at Home (the Alliance) is pleased to support the reintroduction of the Hospice Recertification Flexibility Act in the House of Representatives. This bipartisan legislation, H.R.1720, would extend telehealth flexibilities for hospice face-to-face (F2F) recertification. The F2F encounter is performed by a physician or nurse practitioner to evaluate the patient and collect clinical information used in determining continued eligibility for hospice. Introduced by Representatives Carol Miller (R-WV) and Jared Golden (D-ME), the bill would extend the F2F recertification flexibility for providers until December 31, 2027. Beginning January 1, 2026, the legislation also includes important guardrails to ensure appropriate use and requires the Centers for Medicare & Medicaid Services (CMS) to create a modifier to collect data on when the F2F encounter is conducted via telehealth. The Alliance, then through its legacy organizations, worked with lawmakers to ensure continued care transformation and access to care for high-quality providers. [Click on the title's link to continue reading.]

Contemporary patterns of end-of-life care among Medicare beneficiaries with advanced cancer JAMA Network - JAMA Health Forum; by Youngmin Kwon, PhD; Xin Hu, PhD, MPSH; Kewei Sylvia Shi, MPH; Jingxuan Zhao, MPH, PhD; Changchuan Jiang, MD, MPH; Qinjin Fan, MS, PhD; Xuesong Han, PhD; Zhiyuan Zheng, PhD; Joan L. Warren, PhD; K. Robin Yabroff, PhD, MBA; 2/21/25Conclusions: In a contemporary cohort of older Medicare decedents originally diagnosed with advanced breast, prostate, pancreatic, or lung cancer, we found that many patients continue to receive potentially aggressive interventions at EOL at the expense of supportive care services. To make meaningful improvements in the quality of EOL care, a multifaceted approach that addresses patient, physician, and system-level factors associated with persistent patterns of potentially aggressive care will be required. Editor's note: Though published just one week ago--February 21--this journal article is already being used extensively, as demonstrated in our posts on 2/24 and 2/25.

Palliative care advocates at the World Health Organization executive board meeting ehospice; by Stephen Connor, Executive Director, Worldwide Hospice Palliative Care Alliance (WHPCA); 2/19/25 The World Health Organization (WHO) is in turmoil with the planned withdrawal of funding and membership from the USA. About 20% of the WHO budget is from the US and withdrawal of all USAID funding is causing serious problems worldwide. Many member states are increasing their dues to WHO to help offset this loss, but these are difficult times for public health. These issues were front and center at the meeting of the WHO Executive Board 3-11 February. .. The Worldwide Hospice Palliative Care Alliance (WHPCA) and the International Association for Hospice and Palliative Care (IAHPC) are the two organizations presently in official relations with WHO and we work together to cover the many health issues. Editor's note: For current information from USAID, visit www.usaid.gov. 

What's driving change in end-of-life care for February 2025 Teleios Collaborative Network (TCN); podcast by Chris Comeaux; 3/5/25 In this episode, Chris Comeaux and Cordt Kassner, PhD—Publisher of Hospice & Palliative Care Today and CEO/Founder of Hospice Analytics—unpack the latest trends shaping end-of-life care in America.  Drawing on extensive experience and data-driven insights, they spotlight key Hospice headlines, research, and podcasts influencing the Hospice sector.  … Plus, Cordt delivers a masterclass on Hospice technology, offering practical tools and strategies to enhance care delivery.