Literature Review

The Alliance responds to Senate passage of Reconciliation Bill National Alliance for Care at Home, Alexandira, VA and Washington, DC; Press Release; 7/1/25 The National Alliance for Care at Home (the Alliance) issued the following statement today in response to the Senate’s passage of the “One Big Beautiful Bill Act,” also known as the Reconciliation bill. “The Alliance is alarmed by the Senate’s passage of the One Big Beautiful Bill Act, which prioritizes misplaced budget cuts over the health and wellbeing of our most vulnerable. The legislation will reduce access to care and support for the millions of Americans who rely on home and community-based services (HCBS),” said Alliance CEO Dr. Steve Landers. ... “The Alliance continues to maintain that the complexity of the Medicaid program makes it nearly impossible to reduce expenditures by the amounts contemplated by this legislation – potentially exceeding $1 trillion over ten years – without impacting services to older adults and people with disabilities. The Alliance will advocate on behalf of Medicaid enrollees, families, and providers nationwide ...

The greatest financial threat to hospitals, per revenue cycle leaders  Becker's Hospital Review; by Andrew Cass; 7/1/25Nearly half of hospital revenue cycle leaders view payer denials as the single greatest threat to their organization’s financial performance, according to a report from RCM company Knowtion Health, featuring joint research with Healthcare Financial Management Association. The report is based on a nationwide survey of 147 revenue cycle leaders, according to a June 26 Knowtion news release. 

Provider payment incentives: Evidence from the U.S. hospice industry ScienceDirect - Journal of Public Public Economics; by Norma B. Coe and David A. Rosenkranz; online ahead of print for August 2025 (retrieved from the internet 7/1/25) Highlights

Families demand end to Medicare waiting period for early-onset Alzheimer’s patients Washington Examiner; by Elaine Mallon; 6/15/25 Jason Raubach was diagnosed at 50 years old with early-onset Alzheimer’s disease — a diagnosis that affects nearly 200,000 Americans. He received the diagnosis in 2018, completely upending life for his family. His youngest child was just a freshman in high school. ... Shortly before receiving an official diagnosis, Jason Raubach lost his job, having to move his family onto a consolidated omnibus budget reconciliation act health plan, or COBRA plan, which allows a person to keep their health insurance even after losing their job. “It wasn’t cheap,” Elizabeth Raubach said.However, once diagnosed, Jason Raubach had to wait two and a half years before he could receive coverage under Medicare, health insurance for those 65 years and older or those with qualifying disabilities. But Elizabeth Raubach, along with dozens of other caretakers for people diagnosed with Alzheimer’s, called on Congress in a letter to eliminate the 29-month waiting period required for those under the age of 65 to receive coverage under Medicare. ...

National Alliance: Proposed 2.4% hospice payment update would create shortfall Hospice News; by Jim Parker; 6/11/25 The U.S. Centers for Medicare & Medicaid Services’ (CMS) proposed 2.4% hospice base rate increase is woefully inadequate, and new physician attestation requirements may place undue burdens on providers, according to comments from the National Alliance for Care at Home. The Alliance on Tuesday released its public comments on the 2026 hospice payment rule, which stated that the proposed increase will not adequately cover hospices’ rising costs for supplies, labor, travel and other expenses. 

Rosen introduces bipartisan bills to expand access to palliative care, hospice careJacky Rosen, U.S. Senator for Nevada, Washington, DC; 6/5/25 U.S. Senator Jacky Rosen, co-founder and co-chair of the bipartisan Senate Comprehensive Care Caucus, announced the introduction of a pair of bipartisan bills to expand access to palliative and hospice care. The Expanding Access to Palliative Care Act with Senators Barrasso (R-WY), Baldwin (D-WI), and Fischer (R-NE) would establish a demonstration project through Medicare to expand access to palliative care at the time of diagnosis of serious illness or injury. The Improving Access to Transfusion Care for Hospice Patients Act with Senators Barrasso (R-WY) and Baldwin (D-WI) would carve out payment for transfusion services within the Medicare hospice benefit, allowing for separate billing to Medicare for transfusions. This would improve access to hospice care for patients who rely on transfusion care to maintain quality of life.

Home health provider Intrepid USA files for bankruptcy Home Health Care News; by Joyce Famakinwa; 6/3/25Home health and hospice provider Intrepid USA has recently filed for bankruptcy. The company filed a petition for Chapter 7 bankruptcy in the Southern District Court of Texas in late May, according to court documents. Filing for Chapter 7 bankruptcy results in a straight liquidation, according to Adam Stein-Sapir, a bankruptcy expert at Pioneer Funding Group LLC. ... In 2024, New Day Healthcare acquired Intrepid USA’s hospice operations in Missouri and Texas. Prior to these sales, Dallas-based Intrepid USA operated more than 60 home health and hospice locations across 17 states.

Saugus nurse arrested in FBI raid for alleged part in $2.5 million Medicare [hospice] fraud KHTS - Santa Clarita News, Santa Clarita, CA; by Jade Aubuchon; 5/30/25 Jessa Zayas, aka Jessa Contreras, a vocational nurse, is believed to have committed medicare fraud through two different hospice providers, submitting more than $2,500,000 in fraudulent claims to Medicare. Zayas is the Chief Executive Officer of two hospice providers, Healing Hands Hospice Inc. and Humane Love Hospice. From June 2023 through February 2025, she caused Healing Hands and Humane Love to bill Medicare for millions of dollars’ worth of hospice services that were not medically necessary, not authorized by a physician, and were not actually provided to the patients. ...

SpiriTrust Lutheran says Home Care & Hospice operations will wind down across three counties, end service on July 18th Tri-State Alert, Chambersburg, PA; Press Release; 5/29/25 Earlier on Thursday [5/29], News Talk 1037FM was alerted to a WARN notice from SpiriTrust Lutheran as to a closure of a portion of their business. Throughout the process, that notice has been narrowed down to their Home Care & Hospice (HCH), with the company announcing their plans to discontinue operations out of their Franklin County office which serves clients in Franklin, Adams and York counties. The official closure will be July 18, 2025. ... SpiriTrust Lutheran says that roughly 65 home care and hospice employees will be affected by the shutting, but  some are expected to be reassigned or offered positions within the SpiriTrust Lutheran family of Life Plan Communities ... SpiriTrust Lutheran officials cited the organization’s ongoing challenges mirrored those confronting many similar organizations nationwide – significant increases in the cost of delivering care due to staffing shortages; rising benefit expenses; and the escalating prices for medical supplies and pharmacy. 

Empath Health to sell service center location Hospice News; by Jim Parker; 5/29/25  The Florida-based senior care provider Empath Health is selling one of its administrative service centers, located in Pinellas County in its home state. The center was initially established by Suncoast Hospice, which is now an Empath Health affiliate. The sale is part of Empath’s effort to “realign its physical footprint” to invent more directly in home-based, patient-centered care, according to a statement from the organization. “Selling an underutilized administrative building allows us to reinvest in the people, programs and technology that bring comfort, dignity, and support into homes and communities,” said Jonathan Fleece, president and CEO of Empath Health, in the statement. “It’s a return to our roots and a recommitment to the future.”

Proposed California budget calls for prior authorization for hospice in Medicaid Hospice News; by Jim Parker; 5/22/25 The proposed California budget would require prior authorizations for hospice care within the state’s Medicaid program. Currently, Medicaid managed care plans who provide coverage through the state’s Medicaid system, Medi-Cal, may not perform prior authorizations for hospice. California’s Department of Health Care Services (DHCS) indicated in a 2025-2026 budget revision that this could save $25 million over the next two years and more than $50 million in the long term. If enacted, this would make California the first state in the nation to implement such a rule, according to the California Hospice & Palliative Care Association (CHAPCA). The association contends that the anticipated $25 million in cost savings is “speculative and fails to account for the downstream costs and systemic burdens this proposal would create,” according to a position paper shared with Hospice News. ... CHAPCA recommended to the state government three alternative approaches: ...

Proposed bill would require MA to pay for hospice care Hospice News; by Jim Parker; 5/21/25 Rep. David Schweikert (R-Ariz.) has introduced the Medicare Advantage Reform Act, which among other provisions would require health plans to pay for hospice care. If enacted, the bill, numbered H.R. 3467, would make wholesale changes to the Medicare Advantage program. It would mandate capitated payment models, change risk adjustment methodologies and create new exemptions for physician self-referrals, among other provisions. The potential impacts of moving hospice into Medicare Advantage at this time would be “devastating,” according to the National Alliance for Care at Home. 

[Commentary] It’s time to bring value-based care principles to hospice Medical Economics; by Asher Perzigian; 5/20/25 In the health care industry, the conversation around value-based care (VBC) has been abuzz for a while now. The idea is simple: pay for outcomes, not for services, and shift our mindset from volume to value as we reduce unnecessary care, improve outcomes and bend the cost curve. However, when we talk about VBC, we often overlook a critical part of the health care continuum: hospice care. And when it comes to end-of-life care, traditional measures like survival rates and reduced readmissions lose their relevance. Hospice embodies some of the deepest principles of VBC: aligning care with patient goals, avoiding unneeded interventions and supporting the person as a whole. Here’s what primary care physicians need to know about the integration of value-based principles in hospice care.