Legislation related to palliative care has increased significantly at the state level since 2009, with 819 bills introduced and 30% passed, according to a study in JAMA Network Open. Despite this growth, researchers said policy and regional gaps persist, particularly in Midwestern states, where 45 bills were passed between 2009 and 2023.

Legislative activity tied to care capacity: "Substantial regional disparities in legislative activity likely reflect broader inequities in policy engagement, as states with higher legislative activity typically have stronger palliative care capacity," researchers said.

Epidemiologist Maureen Canavan and Dr. Kerin Adelson, chief quality and value officer at the MD Anderson Cancer Center, discuss the need for policy changes to improve end-of-life care access. They highlight the disparity in reimbursement between high-cost treatments and essential hospice and home care. "If we have improved reimbursements for hospice care or home supportive care, this goes back to what Karen was just saying. Patients can be at home, they can be with their family, and they can still be receiving care that helps them." Canavan says.

Palliative care nurse Marina Sargin emphasizes the comprehensive and compassionate approach of palliative care. "We don't just treat illness, we treat the whole person," Sargin said. "We partner with patients and families to ensure care provided aligns with their values and preferences."

A study in the journal Maturitas found that women with chronic pain earlier in life, especially chronic widespread pain, were more likely to experience multiple bothersome symptoms during menopause. Chronic pain at age 44 was linked to higher odds of being in the high symptom burden class and the vasomotor symptom class.

Data showed that 43.3% of patients ages 65 and older with rheumatic conditions received at least one opioid prescription in 2021, with about 20% receiving prescriptions for 90 days or more, researchers reported at the American College of Rheumatology's annual meeting. About two-thirds of high-dose prescriptions were written by non-rheumatologists. Data came from the ACR's RISE registry and Medicare records.

The CMS is facing a critical staffing shortage, exacerbated by a recent government shutdown and cuts at HHS, health policy experts say. Increased staffing is needed to ensure effective communication and delivery of Medicare benefits, as nearly half of the CMS workforce was furloughed and a 15% reduction in staff has been noted recently.

Medicare Advantage enrollees have access to about 48% of the physicians that are available under traditional Medicare, according to a KFF analysis of MA provider directories from 2022. The study found significant disparities in network coverage across counties, with access ranging from 18% of physicians for traditional Medicare beneficiaries in San Diego to 58% in Pima, Ariz.

Home automatic external defibrillators may help improve survival in cases of shockable cardiac arrest, but they are not currently cost-effective, according to a study in JAMA Internal Medicine. The cost per quality-adjusted life-year was $4.5 million, exceeding the $200,000 threshold for cost-effectiveness. Researchers noted that about 70% of the more than 300,000 out-of-hospital cardiac arrests each year occur at home and less than 10% of people survive to hospital discharge.