Literature Review

Defining palliative care quality in a tight reimbursement environment Hospice News; by Holly Vossel; 1/27/26 Palliative care delivery is undergoing an evolutionary period of change. These services are offered in several different ways across the country, which brings both benefits and challenges when it comes to defining quality in the space. Today’s palliative care providers are shaping the outlook of the field, but through diversified approaches, according to Brynn Bowman, CEO of Center to Advance Palliative Care (CAPC). The field is reaching a pivotal stage when it comes to supply and demand or resources, an issue that greater standardization could help to address, she indicated. 

The malady of delayed palliative care McKnights Long-Term Care News; by Avi Steinberg; 1/21/26 This article asserts that while nursing homes face increasing pressure to deliver value-based, goal-concordant care, palliative care—one of the most effective tools to achieve these aims—remains underused and introduced far too late. The problem is not a lack of evidence, but systemic barriers: delayed identification, misaligned payment models, and workforce shortages. Earlier integration of palliative care can reduce unnecessary hospitalizations, lower costs, and improve resident and family experience. Treating palliative care as a standard of care rather than a last resort is an operational necessity for long-term care.

Alliance responds to MedPAC vote on home health and hospice payment recommendations National Alliance for Care at Home, Alexandria, VA and Washington, DC; Press Release; 1/15/26 The National Alliance for Care at Home (the Alliance) is alarmed by the Medicare Payment Advisory Commission’s (MedPAC) vote today to approve draft recommendations that would significantly reduce home health payment rates by 7% for calendar year 2027 and eliminate payment updates for hospice care in fiscal year 2027.  ... For hospice, the elimination of payment updates would reduce spending by $250 million to $750 million over one year and between $1 billion and $5 billion over five years. 

Hospice job vacancy rates fall in 2025; nurse wage gains slow Hospice News; by Jim Parker; 12/29/25 Job vacancies among hospice employers dropped to 12.78% in 2025 from 14.03% in 2024. Meanwhile, the rate of pay increases for registered nurses has fallen to 3.58% this year, compared to 2024’s 3.97%. This is according to a new salary and benefits report by the Hospital & Healthcare Compensation Service (HCS), the National Alliance for Care at Home and LeadingAge. The report also identified a decline in registered nurse turnover among hospices, to 25.48% from 26.82% year over year. 

'It has made my life a lot easier': New Ohio program pays people to care for their loved ones at homeWTOL-11, Columbus, OH; by Kevin Landers; 11/24/25 Mark Straub, of Delaware County, started caring for his 93-year-old mother about two years ago. As much as he loves to have his mother at home instead of a nursing home, caring for a loved one 24/7 brings with it stress, both emotional and financial. ... The average cost of in-home care in Ohio is $60,238, according to CareScout. The average cost of nursing home care is $108,500 a year, or about $9,000 per month. Thanks to a new program in Ohio, those who care for a loved one at home are about to get financially easier. It’s called Structured Family Caregiving, or SFC. Currently, at least 11 states have formal Medicaid SFC programs that pay family members. “I didn’t believe it at first, until I got that first paycheck and I really wanted to cry, “ said Tsavaris.

Hospice: Track errors, payment caps to avoid facing costly penalties Home Health Line, DecisionHealth; by MaryKent Wolff; 11/13/25 Keep a close eye on possible claim and billing mistakes that could lead to issues related to your payment cap. While increased revenue may seem like a good thing for providers, overpayments could lead to heightened scrutiny and financial hardships for your agency. [May require subscription for additional information]

The Valerie Fund pledges $3.5 million to establish new pediatric pain and palliative care program at Hackensack Meridian Joseph M. Sanzari Children’s Hospital News Wise, Hackensack, NJ; by Hackensack Meridian Health; 11/3/25 Hackensack Meridian Joseph M. Sanzari Children’s Hospital today announced a transformative, 5-year, $3.5 million commitment from The Valerie Fund to significantly expand its Pediatric Pain and Palliative Care Program. The landmark donation will establish The Valerie Fund Pediatric Pain and Palliative Care Program at the Joseph M. Sanzari Children’s Hospital, located at Hackensack University Medical Center in Hackensack, NJ, ... This new partnership will allow the hospital to care for more people annually, growing from approximately 1,750 to 3,500 patient visits. 

[United Kingdom] Petition to save hospice beds going to Number 10 BBC News; Phil Shepka; 11/3/25 Families and MPs campaigning for beds to be saved at a hospice are to hand a petition with more than 15,000 signatures to Number 10 Downing Street. Nine inpatient beds at the Cambridge-based Arthur Rank Hospice are expected to close after the trust that operates nearby Addenbrooke's Hospital removed funding. ... Among those planning to attend Downing Street trip include those whose loved ones were cared for by the hospice. The funding cuts, announced last month, amount to £829,000 a year and will reduce the hospice's inpatient unit bed capacity from 21 to 12. 

Economic benefits of investment in palliative care: An appraisal of current evidence and call to actionJournal of Pain and Symptom Management; by Liz Gwyther, Maya Jane Bates, Bach Tran, Liz Grant, Richard Harding, Eric L. Krakauer, Peter May, Eve Namisango, MR Rajagopa, Eleanor Reid, Charles Normand; 9/25This article summarises the literature suggesting that palliative care can provide cost savings to society as a whole (health systems, patients, families) as well as providing good care in line with patient preferences. The evidence indicates that palliative care is effective in providing patient-centred care, in managing symptoms and patient distress, and in saving money for both the family and the health system. Funding mechanisms for palliative care may exist in high-income countries, but many low-and middle-income countries do not yet have sustainable mechanisms of funding palliative care services.

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. 

Bridging gaps in palliative care for undocumented immigrants using the social determinants of health frameworkAmerican Journal of Hospice and Palliative Medicine; by Lisa Cross, Rachael Salguero; 9/25Systemic policies and inequities, rather than immigration status itself, create barriers to health. In the United States, an estimated 11 million individuals live without legal authorization, a population that faces profound challenges in accessing equitable care. These barriers pose particular difficulties for palliative care nurses in recognizing and addressing the needs of undocumented immigrants. Identifying nursing interventions in this manner aligns with the overarching goals of the American Nurses Association and reflects the principles of ethical compassionate palliative nursing.

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.