Literature Review

North Carolina hospitals wipe out $6.5B in medical debt Becker's Hospital Review; by Andrew Cass; 10/13/25 North Carolina’s medical debt relief program has surpassed its initial financial projections, relieving more than $6.5 billion in medical debt from 2.5 million residents over the past year. ... The North Carolina Department of Health and Human Services partnered with Undue Medical Debt — formerly RIP Medical Debt — to support participating hospitals and help them identify medical debt that is eligible for relief. Hospitals are continuing to work with Undue Medical Debt to facilitate full implementation of relief over the next year. 

Seasons Hospice hosts commemoration as it closes hospice house, forges ahead with in-home care KTTC, Rochester, MN; by Caitlin Alexander; 10/10/25 Local nonprofit organization Seasons Hospice hosted a somber but significant moment on Friday as it commemorated its hospice house. After more than 25 years, Seasons Hospice is closing the doors of the hospice house, as it now shifts its focus to serving patients and families with in-home hospice care. “I had a hard time at first accepting that and getting beyond it, but I did,” one of the founders, Sarah Oehlke, said. “I’m very grateful that you have sustained our quality-of-care standards for all of the years.” “We have together provided comfort, dignity and compassion to countless families during life’s most poignant moments,” Board President Dawn Beck said. ... Seasons Hospice previously spoke about a declining census at the hospice house, especially in recent years, noting the shift toward people wishing to spend their final days in their homes with loved ones.Editor's Note: This Seasons Hospice is in Rochester, Minnesota; not to be confused with other hospice organizations throughout the nation with "seasons" in its name. They gave their hospice house both a "good life" and "a good death." We draw attention to the shift they described "toward people wishing to spend their final days in their homes with loved ones," and will continue to be on the lookout for similar trends. To quote from an ancient poet, "To everything there is a season ..." We wish Seasons Hospice well through its continued transitions.

Home health & hospice's top advocacy priorities TIMSHME.com; by Steve Landers; 10/5/25 The National Alliance for Care at Home (the Alliance) is the largest organization representing, advocating for and convening providers of home-based care, representing over 1,500 organizations and more than 10,000 agencies serving millions of people nationwide. ... Last month, the Alliance convened more than 230 frontline providers and leaders in Washington to advocate for these priorities.  ... Advocates shared the key issues impacting care, why it matters and what Congress should do about it.

Good Samaritan announces transition of hospice services Good Samaritan, Vincennes, IN; Press Release by Good Samaritan; 10/3/25 Good Samaritan [in Vincennes, Indiana] has announced the difficult decision to close its hospice program effective December 31, 2025. The decision, made by the hospital’s Executive Team and Board of Governors, follows a careful evaluation of health care trends and reflects Good Samaritan’s commitment to responsible stewardship and long-term sustainability. “Since its beginning, our hospice team has provided extraordinary, compassionate care to patients and families across our region,” said Rob McLin, CEO of Good Samaritan. “We hold deep respect for that legacy and are committed to supporting our patients, families, and hospice team throughout this transition.”

[United Kingdom] 2 in 5 hospices planning to make cuts this year ehospice; by Hospice UK; 9/24/25 Data from Hospice UK reveals that as many as 2 in 5 hospices are planning to make cuts this year. With demand for services rising fast, the stark reality of insufficient funding leaves hospices with no option but to shrink services just as they should be expanding. Toby Porter, CEO of Hospice UK says: “Hospices are on the brink. Recent short-term funding for hospices in England, Scotland and Wales has been a genuine help, but as costs continue to snowball and demand keeps rising hospices can’t keep up and many are making or considering cuts. 

Hospice, palliative care services yield high quality, cost savings Hospice News; by Holly Vossel; 9/22/25 Hospice and palliative care services can result in better outcomes and reduced costs, recent research has found. A recent study by Empassion Health examined 45,957 seriously ill patients receiving supportive care through the organization from January 2023 to April 2025. The study found a 35% reduction in total cost of care per patient during the final year of life when compared to other individuals. ... The study illustrates the significant quality and cost impacts of hospice and palliative care delivery, Robin Heffernan, CEO and co-founder of Empassion Health, said ... 

Serious falls resulting in hospitalization among Medicare-enrolled nursing home residents, July 2022–June 2023HHS Office of the Inspector General; Report number: OEI-05-24-0018; 9/18/25This OIG data snapshot accompanies the report, Nursing Homes Failed To Report 43 Percent of Falls With Major Injury and Hospitalization Among Their Medicare-Enrolled Residents, OEI-05-24-00180. The snapshot found that between July 1, 2022, and June 30, 2023, more than 42,000 Medicare-enrolled nursing home residents experienced serious falls resulting in major injury and hospitalization, and 1,911 died during their hospital stays. The data indicated that most residents had known fall risk factors prior to their injuries, and falls were more common among female, older, and short-stay residents. Nursing homes with lower nurse staffing levels and lower quality ratings had higher fall rates. These preventable events reduced residents’ quality of life and cost Medicare and enrollees over $800 million, underscoring the need for stronger fall prevention and quality improvement efforts in nursing homes. 

Study finds hospice providers “game” Medicare Payment Cap, but with modest impact on costs Penn LDI - Leonard Davis Institute of Health Economics; by Julia Hinkcley, JD; 9/16/25 ... Each year, about half of Medicare beneficiaries who die receive hospice services. A new study by LDI Senior Fellow and Director of Research Norma Coe and her colleague David Rosenkranz shows that some hospice agency decision-making may be intended to increase payments by undercutting the annual revenue cap that Medicare imposes. But this “gaming” of the payment rules creates only modest increases in both hospice enrollment and spending. The study’s findings also support MedPAC’s view that wage index-adjusting the cap could make it more equitable across hospice programs, but the authors caution that the MedPAC proposal to reduce the cap by 20 percent might lead some hospice providers to close, and therefore requires more analysis.

CMS launches landmark $50 billion Rural Health Transformation Program CMS Newsroom - Rural Health; Press Release; 9/15/25 Today [9/15], the Centers for Medicare & Medicaid Services (CMS) unveiled details on how states can apply to receive funding from the $50 billion Rural Health Transformation Program created under the Working Families Tax Cuts Act to strengthen health care across rural America. This unprecedented investment is designed to empower states to transform the existing rural health care infrastructure and build sustainable health care systems that expand access, enhance quality of care, and improve outcomes for patients. ... The Rural Health Transformation Program invites all 50 states to apply for funding to address each state’s specific rural health challenges. 

Fulfilling end-of-life dreams: A scoping review of bucket lists in palliative and hospice care Palliative Supportive Care - Cambridge University Press; by Swasati Handique, Michael Bennett and Scott D Ryan; 9/12/25 Results: Four major themes were established using thematic content analysis: (1) impact on holistic well-being, (2) role of family in wish fulfillment, (3) cultivation of gratitude, and (4) collaborative leadership in wish fulfillment. In wish fulfillment, the results significantly pointed to the need for more intricate evaluation among patients and interventions that cover beyond the physical aspect. Significance of results: Palliative and hospice care settings should work toward securing sustainable funding for structured wish-fulfillment programs to address existing accessibility gaps and further enhance the holistic nature of care in these settings. Editor's Note: For hospice organizations that can receive donations, setting up a Wish/Bucket LIst fund makes for a meaningful, easy-to-demonstrate ROI on donated gifts. You need to have some type of discretionary review/approval process in place, with assurances of confidentiality when important to the person and/or family.

Research digs into costs, opportunities in hospice, palliative care Hospice News; by Jim Parker; 9/9/25 Researchers have recently uncovered significant financial trends taking shape in hospice and palliative care. Issues examined relate to cost-effectiveness, Medicare Advantage spending patterns, caregivers’ financial challenges and the cost-effectiveness of palliative care.

CMS: Annual Change in Medicaid Hospice Payment Rates—ACTIONCMS, Department of Health and Human Services; email from Rory Howe, director; 9/5/25The Centers for Medicare and Medicaid Services (CMS) has released the Medicaid hospice rates for FY 2026. They are slightly different than the Medicare rates and should be used when billing for Medicaid hospice patients. This memorandum contains the Medicaid hospice payment rates for federal fiscal year (FY) 2026. The rates reflect changes made under the final Medicare hospice rule published on August 1, 2025 (CMS-1835-F). Please inform your staff and all state agencies in your jurisdiction of these new payment rates, which are effective October 1, 2025. We expect state agencies to share the Medicaid hospice payment rates for FY 2026 with the hospice providers in their state.

Navigating the Wage Index: Insights from industry experts Teleios Collaborative Network (TCN); podcast by Chris Comeaux with Annette Kiser and Judi Lund Person; 8/20/25 The healthcare landscape is transforming before our eyes, shifting away from hospital-centered care toward home-based models.  This fundamental change raises urgent questions about Medicare's outdated reimbursement systems, particularly for Hospice providers facing a mere 2.6% rate increase while battling significant inflation. Join us in this illuminating conversation and in-depth discussion with industry experts Annette Kiser, Chief Compliance Officer with Teleios, and Judi Lund Person, Principal, Lund Person & Associates LLC, as they sit down with Chris and explore the complexities of the final 2026 Hospice Wage Index and its impact on Hospice organizations.