Literature Review

Where comfort and nutrition meet: A case series of children with severe neurologic impairment receiving home parenteral nutrition at the end of lifeNutrition in Clinical Practice; by Dana Steien, Erin Alexander, Molissa Hager, Andrea Armellino, Megan Thorvilson; 9/25Increasingly, home parenteral nutrition (HPN) ... is used for intractable feeding intolerance (IFI), which can occur near the end of life (EOL) in children with severe neurological impairment (SNI). [Four cases were retrospectively examined and we] found that the pediatric palliative care team (PPCT) was involved in all cases during HPN decision-making and planning. The pediatric nutrition support team (PNST) and PPCT collaborated to provide individualized, goal-directed care. All [patients] were enrolled in hospice while receiving HPN. HPN at EOL requires careful ethical consideration, particularly of autonomy because families often find comfort in providing nutrition.

Shutdown places brakes on hospital-at-home, sending hundreds back to strained hospitals McKnights Home Care; by Adam Healy and Liza Berger; 10/1/25The shutdown of the federal government Wednesday has brought the hospital-at-home program to a screeching halt, resulting in hundreds of patients being discharged from the program or sent to hospitals for continuation of care, stressing an already-taxed healthcare system, providers disclosed to McKnight’s Home Care Daily Pulse. ... Several weeks ago, the Centers for Medicare & Medicaid Services instructed hospital-at-home programs to discharge or return patients to the hospital as of Tuesday. CMS also said it no longer would accept waiver requests for participation in the AHCaH initiative after Sept. 1, 2025. Late Wednesday, CMS announced that it will allow up to 60 days of noncompliance with the AHCaH waiver. 

68 hospitals, health systems cutting jobs Becker's Hospital Review; by Kelly Gooch and Kristin Kuchno; 8/29/25 A number of hospitals and health systems are reducing their workforces or jobs amid financial and operational challenges. [Listed] are workforce reduction efforts or job eliminations announced in 2025.

Medicare Advantage growth drives changes in post-acute care Managed Healthcare Executive; by Briana Contreras; 7/28/25 A new report released today by Trella Health revealed major shifts are underway in post-acute care as Medicare Advantage (MA) enrollment grows, care transitions evolve and providers navigate the challenges of value-based care. The Post-Acute Care Industry Trend Report looked at national and state-level trends in home health, hospice and skilled nursing using the latest Medicare claims and enrollment data. One of the most significant shifts is the continued rise of MA enrollment. The report shared that as of February 2025, more than half of Medicare beneficiaries (55.4%) are enrolled in MA plans, with 30 states reporting MA enrollment over 50%. This shift is changing how patients access care—more so in home health.

Health economic analysis of an all-virtual, at-home acute care modelJAMA Network Open; Brad Spellberg, MD; Christopher Lynch, MD; Hal F. Yee, MD, PhD; Josh Banerjee, MD; 6/25Hospital-at-home care models send staff, durable medical equipment (DME), and therapeutics (eg, intravenous infusions) to patients’ homes to provide care. In the US, Medicare requires in-person evaluations at least twice daily to receive payment for hospital-at-home services. In the UK National Health Service, virtual wards at home are increasingly being used in lieu of inpatient care. This economic evaluation of ... patients receiving all-virtual, at-home acute care ... found that the virtual program was cost-saving (due to avoided variable hospital costs) only for unfunded patients or patients with Medicaid, but was cost-losing for Medicare and commercially insured patients due to substantial lost inpatient revenue. These findings suggest that current payer rates for inpatient care financially disincentivize development and implementation of novel acute, at-home care models, but a simple reimbursement schema could enable net savings to both hospitals and payers.

Sutter’s CEO outlines its billion-dollar expansion and what’s next Becker's Hospital Review; by Kelly Gooch 7/2/225 Sutter Health is doubling down on its growth strategy, with a focus on expanding access and attracting more physicians to California. Headquartered in Northern California, with executive offices in Sacramento and Emeryville, the health system‘s 57,000 staff and clinicians and 12,000 affiliated physicians provide care to more than 3.5 million Californians. Now, the organization counts San Francisco’s East Bay region among its opportunities for growth, President and CEO Warner Thomas told Becker’s.

‘It’s going to be the expectation’: Alternative care models reshape home-based care Home Health Care News - Hospital at Home; by Joyce Famakinwa; 6/10/25 At-home care providers are looking to the future. This means seriously investing in alternative home-based care models, such as hospital-at-home and Program of All-Inclusive Care for the Elderly (PACE). DispatchHealth, Contessa Health and Alivia Care are some of the organizations that have jumped headfirst into alternative home-based care models, enabling the creation of more comprehensive care delivery models. While alternative care models come with inherent challenges, including a complex regulatory environment and higher capital investments, these models are set to become an expectation for home-based care providers.

A ‘cloak of comfort’: an integrated approach to palliative care for cancer patients Sinai Health; 5/26/25 At Mount Sinai Hospital, palliative care is fully integrated into cancer care, providing comprehensive, person-centered support for those with advanced illness. Palliative care, derived from the Latin pallium meaning “cloak,” offers comfort and support to individuals with serious illnesses. Often misunderstood as solely end-of-life care, it actually provides relief at any stage of a life-threatening illness and can be provided in tandem with cancer treatment. This holistic approach addresses physical, emotional, and spiritual needs, aiming to improve quality of life for both patients and their families. In fact, early integration of palliative care can enhance symptom management, extend life and offer greater support to caregivers. Patients can receive care at Mount Sinai Hospital’s Cancer Care Clinic, at home through the Temmy Latner Centre’s home palliative care program, and in the palliative care unit at Hennick Bridgepoint Hospital.  

Roughly 40 percent of nurses plan to leave profession within 5 years, survey finds McKnights Home Care; by Adam Healy; 5/13/25 The nursing workforce today is more stable than it was during the height of the COVID-19 pandemic, but a significant share of nurses still plan to leave the profession behind in the next five years, according to the 2024 National Nursing Workforce Survey published in the Journal of Nursing Regulation. ... Approximately 40% of RNs, LPNs and LVNs surveyed said that they planned to leave nursing sometime in the next five years. In 2022, roughly 26% of nurses said the same. The most common reasons nurses cited for wanting to leave their jobs included retirement, stress or burnout, workloads and pressures caused by understaffing, the report noted.

Understanding Conservatory Care Services: A comprehensive overview Articlescad.com; by Jonassen Randall; 4/27/25 As the population ages and healthcare requires evolve, conservatory care services have become a crucial part of the continuum of care for numerous individuals. Unlike standard medical treatment environments, conservatory care services focus on supporting people with persistent conditions or impairments, providing a holistic technique that promotes self-respect and quality of life. This short article will explore what conservatory care services entail, who can benefit from these services, and the various kinds they can take.

Why good palliative care clinicians get fired JAMA Network - Viewpoint; by Abby R. Rosenberg, MD, MS, MA; Elliot Rabinowitz, MD; and Robert M. Arnold; 4/14/25 Even the most seasoned palliative care clinician gets fired. In the past year, one of us was fired after asking whether a patient endorsing suicidal ideation had access to a gun; the patient requested not to see the palliative care team because we asked intrusive questions and documented the encounter. One of us was fired after supporting a family’s decision to discontinue life-sustaining therapies for their loved one with multisystem organ failure; the primary intensivist suggested palliative care overstepped in discussing options for which the family (and clinical teams) was not ready. And one of us was fired after sharing the impression that a patient with cancer was dying; the family suggested they preferred the oncologist’s version of a more hopeful future.

Medicaid’s role in health and in the health care landscape: LDI expert insights and key takeaways from select publications Penn LDI - Leonard Davis Institute of Health Economics, Philadelphia, PA; by Julia Hinckley, JD; 3/17/25... Medicaid accounts for one-fifth of U.S. health care spending and covers more than a quarter of Americans. LDI researchers have examined the services it provides in supporting aging adults, people with disabilities, and children, as well as its role in health crises such as chronic disease and suicide. ... Below are select key findings from recent peer-reviewed research, along with expert insights for policymakers considering changes to Medicaid funding in the federal budget.