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President Obama's administration reversed its decision to revise a Medicare regulation to include paying physicians to discuss good advance care planning with patients. This decision is a setback from an ethical and health care perspective, according to advocates for end-of-life planning.
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Finding a way to serve hospice patients who are spread over a 10,000 square mile area is challenging, especially when some staff members are driving as much as 60 miles one way to reach a patient's home.
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Few nursing homes have a reliable process to help residents understand and document their end-of-life wishes, nor adequate procedures to care for them when they are dying. As a result, residents are often hospitalized during the last weeks or months of life, causing unnecessary suffering and possibly driving up health care costs.
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A majority of charities surveyed saw their fundraising revenue remain stable or increase last year, according to the 2010 Nonprofit Fundraising Survey, a report produced by the Nonprofit Research Collaborative (NRC), a coalition of six fundraising and philanthropic organizations.
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Hospitals might improve their ethics consultation processes if they design and use a brief ethics family assessment tool to determine families' and patients' values, two ethicists say.
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As a result of two cuts to Medicare reimbursement, the hospice industry will see the overall median Medicare profit margin drop from 2% in 2008 to -14% in 2019, according to a study recently released by the National Hospice and Palliative Care Organization (NHPCO).
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The problem of "churning," when individuals cycle on and off Medicaid rolls, is expected to increase after the Medicaid expansion, according to a study published in the February 2011 issue of Health Affairs, "Issues In Health Reform: How Changes In Eligibility May Move Millions Back And Forth Between Medicaid And Insurance Exchanges."
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States have some good fiscal opportunities to expand home- and community-based services (HCBS) in the Patient Protection and Affordable Care Act (PPACA), according to Charlene Harrington, RN, PhD, FAAN, director of the University of CaliforniaSan Francisco's National Center for Personal Assistance Services.
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In previous years, there was a widespread perception that the reason managed care was cost-effective was that services were restricted, according to Alice R. Lind, RN, MPH, senior clinical officer at the Center for Health Care Strategies (CHCS) in Hamilton, NJ. This was a largely undeserved reputation, she says, but it worked against managed care expansion.