Literature Review

NPHI enters new phase of high growth as national community continues to expand National Partnership for Healthcare and Hospice Innovation (NPHI), Washington, DC; Press Release; 8/18/26 The National Partnership for Healthcare and Hospice Innovation (NPHI) is experiencing a period of significant growth, welcoming a growing number of mission-driven, community-based organizations from across the country since its 2026 Summit. ... This continued expansion brings new expertise, perspectives and community connections into NPHI’s national network, strengthening a community united by a commitment to high-quality, compassionate, people-first care. ... In recent weeks, NPHI has welcomed:

Hospice groups ‘disappointed’ by 2027 Final Rule Hospice News; by Jim Parker; 8/3/26 Hospice organizations are expressing “disappointment” following the release of the U.S. Centers for Medicare & Medicaid Services’ (CMS) hospice final rule for 2027. A chief sticking point was the 2.3% base rate increase, which was less than the 2.4% the agency originally proposed. Members of industry trade groups contend that this is an insufficient amount in today’s economy and cost environment. ... New for 2027, the Service and Spending Variation Index (SSVI) includes a scoring system using nine claims-based measures, each representing different aspects of hospice utilization as well as non-hospice spending. This is designed to identify hospices in need of increased transparency and oversight. CMS established the SSVI amid the agency’s concerns over non-hospice spending in particular. The Alliance, LeadingAge and the National Partnership for Healthcare and Hospice Innovation (NPHI) opposed the SSVI in comments on the proposed rule.

National Alliance for Care at Home responds to FY 2027 Hospice Final RuleNational Alliance for Care at Home, Alexandria, VA; Press Release; 7/30/26The National Alliance for Care at Home (the Alliance) today responded to the Centers for Medicare & Medicaid Services (CMS) fiscal year (FY) 2027 Hospice Wage Index and Payment Rate Update final rule, which finalizes payment and regulatory changes under the Medicare hospice benefit. CMS finalized a 2.3% payment update to the Medicare hospice benefit, which continues to fall short of the rising labor and supply costs required to deliver high-quality hospice care. As demand for hospice services continues to grow, payment updates must more accurately reflect providers’ costs so that access to these essential services does not decline.  “CMS’s 2.3% payment update does not reflect the true cost of delivering hospice care and adds further strain to providers who are already stretched thin,” said Jennifer Sheets, CEO of the Alliance. “Compounding that pressure is a Service and Spending Variation Index built on a fundamentally flawed methodology that penalizes legitimate providers for non-hospice claims they have no visibility into nor control over, with no process to review or correct the data before it is made public. This is not a sound approach to program integrity. An inadequate payment update combined with an unreliable oversight tool creates a serious and growing burden for legitimate providers working to serve their communities.” 

NPHI urges CMS and state Medicaid agencies to exempt hospice and palliative care patients from Medicaid community engagement requirements National Partnership for Healthcare and Hospice Innovation (NPHI), Washington, DC; Press Release; 7/23/26 The National Partnership for Healthcare and Hospice Innovation (NPHI) has submitted to the Centers for Medicare & Medicaid Services (CMS) and shared with state Medicaid directors a comment letter urging policymakers and regulators to ensure that individuals receiving hospice and palliative care services are explicitly exempt from Medicaid community engagement requirements during implementation of CMS’s Interim Final Rule (CMS-2454-IFC). The Interim Final Rule (CMS-2454-IFC), issued by CMS on June 1, would implement the statutory Medicaid community engagement requirements established by Congress for certain Medicaid expansion beneficiaries while supporting CMS’s objective of ensuring individuals who are medically unable to meet those requirements retain access to health coverage.

Home health advocates accuse CMS of overreach on fraud-fighting measures McKnights Home Care; by Liza Berger; 7/10/26 While there has been much focus so far on the continuing behavioral adjustments in the recent home health proposed rule, there is another aspect of the rule that has drawn providers’ scorn — the harsh fraud measures. “The rule proposes significant expanded authority for CMS to deny or revoke Medicare enrollment,” Jennifer Sheets, CEO of the National Alliance for Care at Home, said during a webinar hosted by the Polsinelli law firm Thursday. “These enrollment provisions are a particular concern for us.” Sheets pointed out to a provision in the program integrity proposals that would expand the reapplication bar — prohibiting a provider from re-enrolling for up to 10 years — for any enrollment denial reason. “This really concerns us,” she said. “We think it is overreach from CMS, and that 10-year bar is a pretty scary thing to be looking at.”

CHAP: CMS posts Accrediting Organizations (AOs) Oversight Final Rule with Comment Community Health Accreditation Partner; Press Release; 6/16/26 Medicare Program; Strengthening Oversight of Accrediting Organizations (AOs) and Preventing AO Conflicts of Interest, and Related Provisions was posted on the Federal Register Public Inspection desk on 6/12/2026 and is estimated to post in the Federal Register on June 16, 2026. The Centers for Medicare and Medicaid Services (CMS) will accept comments related to the proposed rule through August 15, 2026, 11:59 pm. Information about submitting comments appears at the beginning of the rule. This final rule is effective June 16, 2027.

Medicare hospice: action needed to pay more efficiently for routine home care GAO - U.S. Government Accountability Office; GAO-26-107585; publicly released 6/9/26 Fast Facts

National Alliance for Care at Home responds to GAO report regarding Medicare hospice payment The National Alliance for Care at Home (The Alliance), Alexandria, VA; Press Release; 6/9/26 The National Alliance for Care at Home (the Alliance) today responded to a new report from the Government Accountability Office (GAO) recommending that Congress consider directing the Department of Health and Human Services to restructure the Medicare hospice payment system to better promote routine home care payment efficiency. ... The GAO report asserts that shifting hospice to per-visit payment rates comparable to home health would have reduced Medicare spending by $7.6 billion for a selected group of beneficiaries in 2024. However, these savings are generated in part by paying less to “low visit” hospices that are concentrated in known high-fraud areas. ... 

Hospice advocates push back on CMS’ proposed program integrity scoring system McKnights Home Care; by Liza Berger; 6/3/26 In recent comments to the Centers for Medicare & Medicaid Services, hospice advocates criticized the new scoring system, the Service and Spending Variation Index, or SSVI, that CMS put forth in its fiscal year 2027 hospice proposed rule in April to curb fraud in the sector. They cited a flawed methodology underlying the scores and called for CMS to take down two years of publicly posted data. ...The National Alliance for Care at Home pointed to inaccurate scoring in publicly posted data. “This data could cause substantial reputational harm to hospices for mistakes made by CMS in file construction and assigning scores,” Jennifer Sheets, CEO said.LeadingAge said the nonhospice spending measure “lacks transparency, disregards the influence of size and scale, includes questionable data, and is entirely inactionable for hospices.” Such a measure could target the wrong providers, LeadingAge argued. Editor's Note: Explore details from The Alliance, LeadingAge, and NPHI.

NPHI submits comments on FY 2027 Hospice Proposed Rule, urges CMS to strengthen transparency, support access, and advance meaningful reform  National Partnership for Healthcare and Hospice Innovation, Washington, DC; Press Release; 6/2/26The National Partnership for Healthcare and Hospice Innovation (NPHI), the national voice for nonprofit hospice and advanced illness care, has submitted formal comments to the Centers for Medicare & Medicaid Services (CMS) regarding the Fiscal Year (FY) 2027 Hospice Wage Index and Payment Rate Update, Hospice Conditions of Participation Updates, and Hospice Quality Reporting Program Requirements proposed rule. In the letter, NPHI welcomed CMS’s continued engagement with hospice stakeholders and offered detailed recommendations designed to strengthen patient access, improve transparency, reduce unnecessary administrative burden, and support high-quality, community-based hospice and palliative care. 

NMAHHC supports efforts to combat fraud — warns against unintended harm to patient access Roswell Daily Record, Albuquerque, NM; Press Release; 5/28/26 The New Mexico Association for Home & Hospice Care (NMAHHC) expressed support for federal efforts to address fraud and abuse within the Medicare home health and hospice programs ... However, the association urges policymakers and regulators to ensure enforcement efforts remain targeted and evidence-based so compliant providers and vulnerable patients are not harmed in the process.

The Alliance responds to CMS’s announcement of nationwide enrollment moratoria on hospice and home health providers  National Alliance for Care at Home | The Alliance; Press Release; 5/13/26 On May 13, the Centers for Medicare & Medicaid Services (CMS) announced a six-month national moratorium on hospice and home health enrollment in response to program integrity concerns within the Medicare programs. While the National Alliance for Care at Home (the Alliance) strongly supports efforts to root out bad actors who exploit these essential programs, undermine confidence in care at home, and threaten the patients and families who depend on it, the Alliance has long advocated for targeted strategies that distinguish between high-fraud markets and communities where fraud is not an identified problem and patients already face shortages of providers. 

Palliative care and age-friendly care - CAPC Position Statement CAPC | Center to Advance Palliative Care; Position Statement; 5/11/26 The U.S. health care system is evolving to better meet the needs of a rapidly growing aging population by advancing age-friendly care. CAPC’s position statement outlines how palliative care can accelerate IHI recognition and support success with CMS measures. It also offers practical recommendations for leaders and policymakers to integrate palliative care into age-friendly care.