MedPAC: March 2026 Report to Congress
MedPAC Reports; 3/12/26
Medicare Benefit: National health care spending grew rapidly in 2023 and 2024, by 7 percent in each of these years. By 2024, national health care spending totaled $5.3 trillion. Health care spending has made up an increasing share of the country’s gross domestic product (GDP) over time, rising from about 13 percent of GDP in 2000 to 18 percent in 2024. Medicare spending grew more rapidly than national health care spending in 2023 and 2024 (by 9 percent and 8 percent, respectively), in part due to changes in Part D financing that shifted more of the cost of prescription drug coverage from beneficiaries to the federal government. By 2024, Medicare spending totaled $1.1 trillion—equivalent to 21 percent of national health care spending and 3.8 percent of GDP. (Please see the full report here for additional detail.)

Hospice Chapter here. Highlights include:

• For fiscal year 2027, the Congress should eliminate the update to the 2026 Medicare base payment rates for hospice.
• In 2024, more than 1.8 million Medicare beneficiaries (including more than half of decedents) received hospice services from about 6,700 providers, and Medicare hospice expenditures totaled $28.3 billion. 
• The share of decedents using hospice increased to 52.9 percent in 2024, up from 51.7 percent in 2023, reaching a new high.
• The aggregate FFS Medicare margin for 2023 was 8.0 percent, down from 9.8 percent in 2022. In 2024, cost growth slowed, with hospices’ average cost per day increasing by 1.1 percent. The projected 2026 FFS Medicare margin is 9 percent.

• Calculations based on Tables 10-1, 10-8, and 10-9 (based on 6,706 total hospices in 2024):

• For profit hospices accounted for 82% of hospices (N= 5,497) in 2024; average total cost per day= $147; FFS margin= 13.7% in 2023.
  Nonprofit hospices accounted for 16% of hospices (N= 1,070) in 2024; average total cost per day= $214; FFS margin= -1.3% in 2023.
  Government hospices accounted for 2% of hospices (N= 130) in 2024.
  Urban hospices accounted for 88% of hospices (N= 5,877) in 2024; average total cost per day= $170; FFS margin= 8.3% in 2023.
  Rural hospices accounted for 12% of hospices (N= 829) in 2024; average total cost per day= $156; FFS margin= 5.3% in 2023.

Social Media Watch 3/20/26

• Janet Abrahm, Palliative Care Expert, shares her interview Mastering serious illness communication: An interview with Dr. James Tulsky.
• Ira Byock, Physician and public advocate, comment's on Stacey Smith's (SVP, AccentCare) post regarding the NY Post's article LA's shameful hospice fraud crisis laid bare.
• Ernesto Lopez, shares CMS expanding enhanced oversight programs like PPEO and Expanded Prepayment Review into additional states should get the attention of every hospice leader. These programs are not just regulatory updates. They are signals...

Oversight Committee launches investigation into rampant taxpayer fraud in California hospice programs 
U.S. Committee on Oversight and Government Reform, Washington, DC; Press Release; 3/23/26
Following alarming reports that California officials failed to properly safeguard federal funds, House Committee on Oversight and Government Reform Committee Chairman James Comer (R-Ky.) and Oversight Committee Republicans today launched an investigation into rampant taxpayer fraud in California’s hospice programs. ... The Oversight Committee is now requesting documents and communications regarding California’s oversight and internal controls to detect and prevent fraud for its federally funded hospice programs.
Editor's Note: CMS Testimony at the Oversight Committee by Kim Brandt, Deputy Administrator & Chief Operating Officer, CMS. 

• Read the transcript
• Watch her testimony, starting at 31:35 minute marker

Hearing on “Improving kidney health through better prevention and innovative treatment” 
U.S. House Committee on Ways and Means Subcommittee on Health; written testimony fo Dr. Robert Taylor; 3/18/26

• ... [page 5, paragraph 4] For those who do approach the end of life on dialysis, we have seen that palliative and hospice services are underutilized in the dialysis population. It is important that we ensure that patients at the end of life and their families have the best experience possible. ...
• ... [page 7, under section for"Policy Opportunities"] 4. Permit Concurrent Hospice and Dialysis. Allow patients with ESRD as their primary diagnosis to receive concurrent hospice and dialysis. As noted earlier, we appreciate the support from members of this Committee for concurrent dialysis care for hospice patients and are very active in providing this care to our patients. ...

Building health equity for Minnesota’s Hmong community: The role and impact of the Hmong
Hmong Studies Journal; by Yeng M. Yang; 2/26
This article examines the health care experiences of Hmong refugees in Minnesota and the U.S. since the late 1970s, highlighting major public health challenges as well as notable progress reflecting their resilience. It highlights how Hmong Americans have navigated obstacles to health care such as language barriers, cultural differences, and limited access to culturally competent healthcare, while emphasizing the vital role of the Hmong Health Care Professionals Coalition (HHCPC/ The Coalition).

Lanterns shine light on spiritual, financial help Fort Worth nonprofit gives to terminally ill 
FWR - Fort Worth Report, Fort Worth, TX; by Marissa Greene; 2/16/26 
Nestled within a grove of trees, more than 300 lanterns twinkled around the perimeter of the Keith House on a recent evening in the Clearfork neighborhood. The pulsing glow of the tealight candle inside each white paper bag illuminated a first name and last initial inscribed into the front of the lantern. Each name represented a patient served by Project 4031, a faith-based nonprofit aiming to provide peace and comfort to terminally ill children, adults and families facing end-of-life challenges by easing financial burdens and fulfilling last wishes. 

When words fail, so does care: Why healthcare translation services matter 
Leesville Leaders; by JR Language; 3/19/26 
... Language services in health care mean more than having an interpreter in the room. When we talk about language access in healthcare, we’re referring to two distinct yet equally essential services: medical interpretation and healthcare document translation. Both matter. Neither is optional.

• Medical Interpretation Services ...
• Medical Document Translations ...
• Healthcare Language Access Best Practices ...
• Why “Good Enough” Isn’t Good Enough ...
• What’s Needed: Specialised Skills and Understanding ...
• Building Language Access Into Your Practice ...

The good deaths of people who never marry: Lifelong single people are most likely to die pain-free and at peace. 
Psychology Today; by Bella DePaulo, PhD; 3/8/26 
People who are single and want to stay that way are often taunted with scare stories about what will happen to them toward the end of their life—they will grow old alone, they will die alone, and all the rest. Same for people who have no children. But is the quality of the end of their lives really worse for those who never marry (or never have kids) than it is for those who are married, remarried, divorced, or widowed (or who have grown children)? We now have an answer, and it is not at all what those dire warnings predicted.
Editor's Note: This Psychology Today article provides a new lens in the research we shared on 3/20/26, “We make our own families”: Do child-free people die alone? Hospice worker shares her experience. Important: “child-free” does not necessarily mean a person never married, and “never married” does not necessarily mean a person is child-free. Together, they raise a deeper question: is a “good death” defined by traditional family—or by the presence of meaning, connection, and peace, however we choose to build it?

AMGA calls for total-cost-of-care model for end-of-life care 
Healthcare Innovation; by David Raths; 3/20/26 
Among the recommendations of a value-based care task force of the American Medical Group Association (AMGA) is that CMS should establish a total-cost-of-care model for end-of-life care. AMGA  is a trade association representing multispecialty medical groups and integrated systems of care. More than 175,000 physicians practice in its member organizations. 
Editor's Note: Download the AMGA's 44-page Task Force Recommendations. It details these six foundational pillars they identified:

1. Enhance Patient Engagement: Empower patients to take an active role in their healthcare decisions.
2. Improve Health Outcomes: Address disparities to ensure all populations receive high-quality care.
3. Protect Patient Dignity at End of Life: Promote compassionate care that respects patient preferences.
4. Remove Regulatory and Statutory Barriers: Reduce administrative burdens that impede care delivery.
5. Support Practices Serving Rural and Underserved Populations: Ensure equitable resources and support for all providers.
6. Ensure the Long-Term Sustainability of High-Value Care: Establish a payment model that ensures long-term viability for providers.

Haven Hospice simulations help caregivers understand dementia 
Levy Citizen, Chiefland, FL; by Antoniette Meyer; 3/19/26 
A program offered by Haven Hospice is helping caregivers, medical professionals and community members better understand what daily life can be like for someone living with dementia. ... Through Haven’s Dementia Care Program, participants can take part in hands-on simulations designed to replicate some of the sensory and cognitive challenges people with dementia experience. During the exercises, attendees may wear specialized goggles or gloves, listen to music or attempt tasks that simulate symptoms such as vision loss, hearing impairment, reduced motor function and changes in perception. ... Attendees who participate in the simulations often report that the experience is eye-opening, helping them develop greater empathy and learn ways to communicate more effectively with people living with dementia.
Editor's Note: Experiential education like this offers something lectures alone cannot—an embodied understanding of what it may feel like to live with dementia. These kinds of empathy-building simulations are not only powerful, but also adaptable for many settings. Consider how similar approaches could support your interdisciplinary team, volunteers, and non-clinical staff—especially those who both contribute to patient care in meaningful ways and navigate dementia in their own families.

CMS clarifies hospice revocations, face-to-face encounters 
McKnights Home Care; by Suzy Frisch; 3/24/26 
If a hospice patient is discharged from care or has their benefits revoked, they do not have to complete a waiting period to arrange for new care, according to the Centers for Medicare & Medicaid Services, which provided such clarifications earlier this month. If a hospice patient is discharged from care or has their benefits revoked, they do not have to complete a waiting period to arrange for new care, according to the Centers for Medicare & Medicaid Services, which provided such clarifications earlier this month. 

May your troubles be less, and your blessing be more. And nothing but happiness, come through your door. ~ Irish Blessing