Literature Review

NPHI calls for thoughtful hospice payment reform that rewards high-quality care National Partnership for Healthcare and Hospice Innovation (NPHI), Washington, DC; Press Release; 6/16/26The National Partnership for Healthcare and Hospice Innovation (NPHI)is calling for thoughtful modernization of the Medicare Hospice Benefit while raising concerns about recommendations contained in a recent Government Accountability Office (GAO) report that could fundamentally alter the hospice benefit and potentially lead to substantial changes in provider reimbursement. NPHI is exploring potential reforms to the current hospice payment structure, including steps to reduce incentives for bad actors and poor-quality care by lowering the hospice aggregate cap, and reallocating dollars within the existing payment methodology to better compensate high-quality, mission-driven providers caring for the sickest patients. NPHI believes these types of reforms would better align reimbursement with patient needs, preserve the core principles of hospice care, and encourage providers to deliver care based on patient need rather than financial incentives. ...

GAO uses home health as benchmark to question Medicare hospice payments Home Health News; by Morgan Gonzales with Jim Parker; 6/9/26 ... GAO said Medicare could have saved about $7.6 billion if hospice routine home care from 2022 through 2024 had been reimbursed using adjusted home health per-visit rates rather than hospice’s current per-day payment system, according to a GAO report released Tuesday [6/9]. ... While The Alliance questioned the GAO’s comparison of hospice to home health, Mollie Gurian, vice president of policy and government affairs for LeadingAge, said that the comparison could be a helpful tool.

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.

NPHI concludes record-setting 2026 Summit “Quality in Action” in Chicago National Partnership for Healthcare and Hospice Innovation (NPHI), Chicago, IL; Press Release; 5/2/26 The National Partnership for Healthcare and Hospice Innovation (NPHI), the national voice for nonprofit hospice and advanced illness care, has concluded its 2026 Summit, Quality in Action, at the Chicago Marriott Marquis — marking the largest gathering in the organization’s history. Over three days, nonprofit hospice and advanced illness care leaders from across the country came together around a shared commitment to Quality in Action. The Summit created space for candid discussion and practical exchange, with a clear focus on how nonprofit hospice and advanced illness providers will continue to lead in delivering high-quality, community-based care for patients and their families.

NPHI execs: quality is hospices’ differentiator Hospice News; by Jim Parker; 4/28/26 True quality care transcends government-required metrics and is key to shaping the future of hospice care. This is according to Tom Koutsoumpas, founder and CEO of the National Partnership for Healthcare & Hospice Innovation (NPHI), and Carole Fisher, the organization’s president. While factors like regulatory compliance are crucial to quality, they don’t tell the whole story, Koutsoumpas and Fisher told Hospice News at NPHI’s Annual Summit in Chicago. “Quality is our differentiator. In addition to all the scores, certainly patient and family satisfaction is a huge part of it, making sure that we continue to put the patient and family in the center. ...” Koutsoumpas said. “Do we create an atmosphere of trust? That’s a quality issue."

AAHPM Hospice Statement approved by the Executive Committee on April 17, 2026 American Academy of Hospice and Palliative Medicine; Press Release; 4/17/26 The AAHPM Executive Committee of the Board of Directors, in close coordination with Academy staff and trusted stakeholder partners, has been actively monitoring and discussing recent events and actions, including those by the U.S. Department of Justice (DOJ), Department of Health and Human Services (HHS), as well as Congressional hearings related to hospice fraud. ... The Centers for Medicare and Medicaid Services (CMS) should target fraudulent hospices. We have provided guidance to CMS on our recommendations to do so with precision, including but not limited to identifying red flags such as those below, which should be applied with clinical context and should not be applied mechanically to penalize providers serving complex patient populations. [Continue reading]

New research shows earlier hospice election could save Medicare over $1 billion annually National Alliance for Care at Home, Alexandria, VA; Press Release; 4/23/26 A new analysis commissioned by the Research Institute for Home Care (the Institute) reveals that if Medicare beneficiaries elected hospice care just five days earlier, the program could save between $1.19 billion and $1.5 billion annually.  The analysis, conducted by ATI Advisory, demonstrates how modest, clinically appropriate changes in hospice timing could generate significant Medicare savings while improving patient outcomes. These findings are particularly relevant as Medicare spending on hospice services increases by nearly 10% annually, and overall enrollment of Medicare beneficiaries using hospice continues to grow.

Alliance statement on the Ways & Means Hearing examining fraud, waste, and abuse in Medicare National Alliance for Care at Home, Alexandria, VA; Press Release; 4/21/26 The National Alliance for Care at Home (the Alliance) continues to support efforts by policymakers and regulators to combat fraud, waste, and abuse in the Medicare program. On April 21, the House Committee on Ways and Means hosted a hearing titled “Protecting Patients and Taxpayers: Cracking Down on Medicare Fraud.” The harm experienced by victims of Medicare fraud cannot be overstated. Hospice care exists to provide dignity, comfort, and support at the end of life. When bad actors exploit this trusted system, they don’t just harm individual patients — they erode confidence in the Medicare hospice benefit as a whole. Receiving care at home is the preferred choice for care by many patients and families, and home health plays a vital role in providing skilled care that improves health outcomes and reduces hospitalizations.