Literature Review

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.

Stakeholders fear ‘chilling effect’ of heightened hospice scrutiny McKnights Home Care; by Liza Berger; 4/9/26 Advocates and experts, by and large, are supportive of the federal government’s intense efforts to root out fraudulent hospice providers. But they are also concerned that the laserlike focus on fraud could have unintended consequences for high-quality providers. “We’re certainly hearing from members that they want to know whether policymakers and lawmakers truly see the value of hospice and that, yes, there are bad things going on in California and it’s getting a lot of publicity, but people are concerned that this could have a chilling effect,” Scott Levy, chief government affairs officer for the National Alliance for Care at Home, told McKnight’s Home Care Daily Pulse. “Hospices around the country at large are good people doing incredible work for meaningful periods of time for meaningful periods in their beneficiaries’ lives. And we want to make sure that that doesn’t go backwards.”

Association for Death Education and Counseling celebrates 50 years of advancing grief education and end-of-life understanding ADEC - Association for Death Education and Counseling; Press Release; 4/9/26 The Association for Death Education and Counseling (ADEC®), The Thanatology Association®, is celebrating its 50th anniversary, marking five decades of leadership in the interdisciplinary study of death, dying, and bereavement. ... Looking toward the future, ADEC envisions a world in which dying, death, and bereavement are recognized as fundamental aspects of the human experience rather than topics hidden from public conversation. The organization continues to expand its international reach and public engagement. Through initiatives such as the 50 Futures Global Fund, ADEC will support the distribution of digital grief education resources, training opportunities, and micro-grants to communities around the world.

National Alliance for Care at Home Responds to the FY 2027 Hospice Proposed Rule National Alliance for Care at Home, Alexandria, VA; Press Release; 4/2/26 ... The proposed 2.4% payment update – largely prescribed by law – will still result in challenges for providers delivering care. Cost pressures continue to mount from factors like inflation, workforce shortages, and rising expenses for supplies and services. While the Alliance appreciates that CMS is recognizing hospice providers’ difficult operating environment, this update – after several years of inadequate payment adjustments – will still leave difficulties for providers delivering this vital benefit to the patients and families who depend on it. The Alliance also notes several proposals aimed at increasing oversight and transparency, ...

In fight against fraud, leading national organizations urge CMS to take action while protecting legitimate providers and patient access The National Alliance for Care at Home (the Alliance); Press Release; 3/25/26The National Alliance for Care at Home (the Alliance), LeadingAge, LeadingAge California, and the California Association for Health Services at Home (CAHSAH) in a March 25, 2026 letter to Dr. Mehmet Oz, Administrator, ​the ​Centers for Medicare and Medicaid Services (CMS), commend the agency’s actions to protect Medicare beneficiaries, preserve the integrity of the hospice and home health benefits, and root out bad actors who are exploiting the program and harming patients and families. At the same time, the associations emphasize the need for a carefully targeted federal response to protect current and prospective patients, and preserve access to care delivered by trustworthy providers.

15 hospices incorporated in a single day, in a single suite in Van Nuys Daily Breeze; by Jason Henry; 3/22/26 A group operating out of a Friar Street office building in Van Nuys that advertises “virtual offices” incorporated 22 hospices and home care agencies in one year, including 15 hospices registered in one day to a single suite, according to an investigation by the Southern California News Group. The 15 hospices, all formed in “Suite 205” at 14545 Friar St., later collected $12.3 million from Medicare and Medi-Cal billings in 2023 and 2024, records showed. ... While operating out of the same building is permitted, hospices cannot use the same office, according to Sheila Clark, the president and CEO of California Hospice and Palliative Care. ... She’s been sounding the alarm about fraud risks in Los Angeles’ hospice industry for years now. ...However, these hospices seemingly bypassed that limitation by appending letters from “A” to “P” onto the suite number in official documentation.

Hospice organizations call for Medicare provider enrollment moratorium in California Hospice News; by Jim Parker; 3/20/26 A coalition of hospice and home health industry stakeholders are calling for a statewide moratorium in California on provider enrollments due to widespread Medicare fraud. A key area of focus is the greater Los Angeles County area. The group of providers and associations has written to U.S. Centers for Medicare & Medicaid Services (CMS) Administrator Dr. Mehmet Oz saying that rampant fraud in the state requires federal intervention. The signatories on the letter included the Save Home Health Coalition, California Hospice and Palliative Care Association (CHAPCA) and Texas Association for Home Care and Hospice (TAHCH).

Alliance concerned by MedPAC’s misguided 2026 home health and hospice payment recommendations National Alliance for Care at Home, Alexandira, VA and Washington, DC; Press Release; 3/13/26The National Alliance for Care at Home (the Alliance) is deeply concerned by the Medicare Payment Advisory Commission’s (MedPAC) March 2026 Report to Congress: Medicare Payment Policy. MedPAC’s congressionally mandated report provides analysis and recommendations on various Medicare programs, including home health and hospice. The Commission’s findings focus on payment adequacy, access to care, quality, financial performance, and projections for 2026 and beyond. The Alliance previously expressed concern in response to MedPAC’s vote in January 2026.

Building momentum: How new national Alliance CEO Jennifer Sheets will propel hospice forward Hospice News; by Jim Parker; 2/24/26 The most important lessons in health care leadership are learned at the bedside, according to Jennifer Sheets, the newly appointed CEO of the National Alliance for Care at Home. ... In her first media interview since taking the helm at the Alliance, Sheets spoke with Hospice News about the organization’s priorities for 2026 and beyond, the goals and needs of hospice providers and the lessons she’s learned as a home-based care leader.

Dr. Steve Landers to step down as National Alliance CEO, succeeded by Jennifer Sheets Hospice News; by Jim Parker; 2/11/26 Dr. Steve Landers is stepping down as CEO of the National Alliance for Care at Home effective Feb. 9. Former President and CEO of Caring Brands International and Interim HealthCare Jennifer Sheets will succeed him. Landers led the organization through its integration period. The Alliance is the result of a 2024 merger between the National Hospice and Palliative Care Organization and the National Association for Home Care & Hospice. Sheets will become the Alliance’s new top executive as of Feb. 17. She will also serve as president of the Alliance’s affiliate Research Institute for Home Care.

MedPAC signals need to bolster Medicare physician payments AMA - American Medical Association; by Tanya Albert Henry; 1/27/26 Influential body backs added 0.5% Medicare pay update but backtracks on linking doctor payment to practice-cost inflation. ... The influential Medicare Payment Advisory Commission (MedPAC) voted in January to address inadequate payment for Medicare physician services under current law, once again underscoring a longstanding policy failure that is widely recognized but remains unresolved. MedPAC voted to recommend an additional 0.5% update on top of the updates specified in current law—0.25% and 0.75%—and will forward that recommendation to Congress. 

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.