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.

AI in hospice: What every leader needs to know | part two 
Teleios Collaborative Network (TCN); podcast hosted by Chris Comeaux with Ernesto Lopez; 3/13/26 
... In Part Two of “AI in Hospice: What Every Leader Needs to Know,” Chris Comeaux continues his conversation with Hospice leader and AI innovator Ernesto Lopez to explore how AI can help organizations strengthen compliance, reduce audit risk, and improve the quality of patient care. After nearly 15 years working in Hospice operations, Lopez explains why the industry needs “Hospice-native AI”—technology built specifically for Hospice workflows rather than tools borrowed from other healthcare sectors.  He shares how artificial intelligence can help identify documentation gaps, shorten compliance feedback loops, and give leaders better visibility into their medical records before audits happen.

The non-professional virtues of the hospice volunteer 
Journal of Applied Philosophy; by Michael B. Gill; 3/12/26 
Volunteers have long played a significant role in hospice care. Much of the care volunteers provide consists of weekly hour-long in-home visits. Home-visiting hospice volunteers are not professionals, nor are they strangers or intimates. Hospice volunteers will not typically face moral dilemmas, nor be called upon to make dramatic decisions. Nonetheless, hospice volunteering can exemplify a neglected area of in-between ethics – a subset of what Brownlee has called the ‘ethics of interacting’ – that can redound to the wellbeing of all concerned. ... In this article I explore a type of interaction that exemplifies this third, in-between ethics – that between people on hospice and volunteers visiting them in their homes
Editor's Note: Hospice volunteers—especially those who make home visits—deserve our utmost care in selecting, preparing, supporting, retaining, and thanking. As a crucial refresher, the Hospice Medicare Conditions of Participation set clear expectations for volunteer programs, including Standards §418.78 (a–e) for Volunteers—covering training, defined roles, cost savings, and level of activity—and §418.100(g) regarding the organization and administration of services.

Palliative care often comes late for veterans with COPD; use increases modestly
U.S. Medicine - The Voice of Federal Medicine, Atlanta, GA; by Mary Anne Dunkin; 3/13/26 
Chronic obstructive pulmonary disease (COPD) is associated with substantial symptom burden, functional decline and frequent hospitalizations, making early palliative care an important component of comprehensive management. Yet, despite an increased focus by the VA on such care, new research suggested that many veterans with COPD still receive little or no palliative support—and, when they do, it often begins late in the course of illness. 

Translating palliative care narratives into art: An arts-based knowledge translation pilot with young adult artists 
Palliative Care and Social Practice; by Kristina A. Smith, Philippe Blanchard, Susan Law, and Kelli Stajduhar; 2/25/26 
Objectives: This knowledge translation project explored arts-based approaches for translating palliative care narrative data into creative forms, examining the feasibility of converting research narratives into accessible art forms that could facilitate engagement with death-related topics.
Results: Over 25 artistic works illustrating death and dying experiences were created. The collaborative translation process revealed that undergraduate artists could effectively interpret and visualize complex palliative care narratives through diverse artistic approaches. Course evaluations and informal feedback indicated that artists found the experience meaningful and challenging, and expressed interest in further exploration of death-related topics. 
Editor's Note: Go to this article and scroll down past "Results" to see photos of these artworks and their descriptions.

The case for caregiver support: Better outcomes for people and organizations
CAPC press release; 2/23/26
The Case for Caregiver Support: Better Outcomes for People and Organizations, a new publication from CAPC, outlines how hospital-based psychosocial support for caregivers benefits caregivers, patients, and the hospitals themselves.

How closed-ended survey questions and narrative comments interact in characterizing caregivers’ overall assessment of hospice care 
Rand.org, published in American Journal of Hospice and Palliative Medicine; by Denise D. Quigley, Anagha Alka Tolpadi, Danielle Schlang, Joshua Wolf, Rebecca Anhang Price, Melissa A. Bradley; April 2026 online ahead of  print 
Introduction: Responses to open-ended questions on experience surveys provide rich information and are useful for quality improvement (QI). We examine the usefulness of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Survey comments for informing hospice QI.
Conclusion: Closed-ended questions on the CAHPS Hospice Survey elicit comprehensive insights on hospice care experiences. While many caregivers elected to provide open-ended feedback, a minority of these comments were actionable for QI, and comments did not provide substantial, unique information. CAHPS Hospice Survey measures are sufficient, without open-ended comments, to guide QI, prioritize actions, benchmark performance and assist caregivers in hospice selection.

Alliance submits comment letter on the Department of Education’s notice of proposed rulemaking, ‘Reimagining and Improving Student Education’ (RISE) 
National Alliance for Care at Home, Alexandria, VA and Washington, DC; Press Release; 3/3/26 
The National Alliance for Care at Home (the Alliance) has submitted a response to The Department of Education’s proposed rule, titled Reimagining and Improving Student Education (RISE).  While the Alliance appreciates the Department’s aim of promoting fiscally responsible spending, the comment letter expresses concern that the proposed rule’s narrow definition of professional degree, and the resulting exclusion of nursing, physical therapy, physician assistant, occupational therapy, and social work advanced degree programs, would have a unintended consequence for the healthcare workforce and the millions of Americans who depend on care delivered in the home.

AI and healthcare: Bob Wachter
GeriPAL podcast; Alex Smith, Eric Widera, Bob Wachter; 2/5/26
Today we interviewed Bob Wachter about his book, “A Giant Leap: How AI Is Transforming Healthcare and What That Means for Our Future.” You may recall we interviewed Bob in April 2024 about AI, and at that time he was on the fence about AI – more promise or more peril for healthcare? As his book’s title suggests, he’s come down firmly on the promise side of the equation.

‘Shadow AI’ continues to lurk in healthcare settings
Healthcare Brew; by Patrick Kulp; 2/19/26
A recent survey found close to a fifth of workers admitted to using unapproved tools. At a time when tech companies want to make AI tools as standard-issue as stethoscopes, the technology is seemingly everywhere in the healthcare industry. But some of its use still remains in the shadows, so to speak—ungoverned by workplaces and rife with security and patient safety risks, experts said. This so-called “shadow AI” remains problematic, according to a recent survey from professional software provider Wolters Kluwer: Nearly a fifth (17%) of more than 500 healthcare workers admitted to tapping unauthorized AI in the workplace. And two in five said they’d encountered such a tool but didn’t use it.

Mom of Frosty-loving daughter on hospice shouts out Wendy’s staff for ‘lovely gesture’ 
NBC Today Show; by Heather Marin, RD; 3/13/26 
... [Mary Adams] wanted to give a shoutout to a Wendy’s drive-thru employee in Palm Desert, California, who made her feel seen on a weekly Frosty run that’s deeply bittersweet. ... Purdie’s sister, Gretchen, was diagnosed with glioblastoma in 2023 [... and chose hospice care in January 2025]. Her appetite is limited these days. “Every week,” Purdie explains. “Someone from our family, usually my mom, goes to Wendy’s and gets six chocolate Frostys.” ... When Adams arrived at her local Wendy’s to pick up the weekly supply recently, a staff member recognized her. “Hey, you’re late!” said the team member, handing over the drink tray, “No spoons, right?” “Many days, there are very few reasons to smile while being a caregiver for her terminally ill daughter, but that interaction was a bright spot,” says Purdie. The whole family was touched that someone noticed the routine that is for them both life-sustaining and painful.

New word for the day: Sláinte (pronounced slawn-cha), Irish for "health," "wholeness," and "wellbeing" ~ Happy St. Patrick's Eve to our readers