The State of Hospice Care Takes Center Stage at Coalition for Quality at the End of Life Meeting

Recent controversies around issues of poor quality and fraud among for-profit hospices and current advances in the delivery of palliative care in pediatric populations were the focus of the first statewide Coalition for Quality at the End of Life (CQEL) meeting of 2023, held on March 15 via Zoom. Thirty-seven attendees from across the Commonwealth joined the meeting via Zoom, which was hosted by Jewish Healthcare Foundation COO and Chief Program Officer Nancy Zionts, MBA, and Medical Advisor Judy Black, MD, MHA.

The topic of hospice care and issues around facility ownership, quality, and fraud has garnered much media coverage and discussion since the publication of an investigation by ProPublica and the New Yorker at the end of 2022. To address the challenges facing the industry and changes needed to ensure quality care, the meeting featured a panel discussion moderated by Robert Arnold, MD, Distinguished Service Professor of Medicine; director, Institute for Doctor-Patient Communication, University of Pittsburgh School of Medicine; medical director, UPMC Palliative and Supportive Institute. Panelists included: Theresa Brown, PhD, BSN, RN, nurse, author, patient; Eric Horwith, MSW, LSW, regional manager, Family Hospice of UPMC and UPMC Home Healthcare, and adjunct professor, University of Pittsburgh School of Social Work; Scott Miller, MD, MA, FAAHPM, chief medical officer, Family Hospice of UPMC, and clinical associate professor of medicine, Section of Palliative Care and Medical Ethics, University of Pittsburgh; and Dillon Stein, DO, director, Division of Palliative Care, Butler Health System. Panelists discussed the challenges inherent in the current hospice care payment model and the insufficient oversight on hospice providers, and they detailed opportunities for improving how providers communicate about hospice with patients and families.

Betsy Hawley, executive director of Pediatric Palliative Care Coalition (PPCC), shared updates on PPCC's work to advance the delivery of education and resources to the pediatric palliative care community as well as their advocacy efforts. Their monthly webinar series provides the interdisciplinary team with strategies to improve the care of children with serious illness, and an archive of more than 40 webinars is available for those seeking additional training. PPCC has developed toolkits focused on creative expression, sibling support, caring conversations, and care plans. Their caregiver support offerings include the Firefly Chat App, which enables caregivers to conveniently store information to bring to medical appointments and facilitates bimonthly conversations with caregivers and providers. PPCC also developed the content for the new Pediatric POLST and EMS online learning module.