Literature Review

US health expenditures rapidly accelerating Hospice News; by Jim Parker; 1/14/26 ... Rising health care utilization is the most significant driver of the spending increases, according to CMS. One key factor is that utilization is bouncing back from declines that occurred during the COVID-19 pandemic, according to Micah Hartman, a statistician in the National Health Statistics Group with the Office of the Actuary at CMS. Population growth was also a factor. ... By payer type, private health insurance saw the largest rate of spending growth at 8.8%, followed by Medicare at 7.8% and Medicaid at 6.6%. Out-of-pocket spending rose by 5.9%. ... Hospice care saves Medicare roughly $3.5 billion for patients in their last year of life, according to a joint report from the National Hospice and Palliative Care Organization (NHPCO), the National Association for Home Care & Hospice (NAHC) and NORC at the University of Chicago.

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. 

Top news stories from 2025, and predictions for 2026 by Chris Comeaux and Cordt Kassner | Part 1 Teleios Collaborative Network (TCN); podcast by Chris Comeaux with Cordt Kassner; 1/14/26 This episode of TCNtalks / Anatomy of Leadership brings together a year-in-review and a forward-looking conversation, as Chris Comeaux and Cordt Kassner reflect on the most important healthcare and Hospice stories from 2025 and share their predictions for what lies ahead in 2026. In Part One, Chris and Cordt review key headlines from late 2025, connecting policy shifts, technology trends, workforce realities, and financial pressures to the everyday leadership decisions facing hospice and healthcare organizations.  Rather than reacting to news in isolation, the discussion focuses on how these forces intersect at the front lines of care.

CMS, hospice groups mull Wage Index reform Hospice News; by Jim Parker; 1/13/26 Some stakeholders in the hospice space are seeking reforms to the hospice wage index. ... CMS has given indications that it would mull changes to the hospice wage index. In 2025, the agency convened a technical expert panel to consider the issue. One point of discussion is the application of new data sources, including potential changes to hospice cost reports. ... One proposal discussed within the panel would be to revise the hospice cost report to collect accurate information about costs related to full-time employees, ... To implement a new wage index methodology, CMS would also have to go through a proposed rulemaking process, including public notice and a comment period. With any wage index changes, some hospices would “win” and others would “lose.” Some providers may see higher payments as a result, whereas others may see their rates go down. ...

What to expect in US healthcare in 2026 and beyond McKinsey & Company; by Neha Patel and Shubham Singhal with Ankit Jain; 1/12/26The healthcare industry faces successive waves of challenging trends, with glimmers of opportunity in select segments. US healthcare system continues to face considerable financial strain, although there are pockets of opportunity. ... Payers and providers have borne the brunt of the decline to date and will continue to feel financial pressure in the immediate future. ... Meanwhile, providers could experience an increase in uncompensated care and loss of reimbursement. ... Post-acute care is positioned for stronger performance over the next several years, with continued growth in home health and hospice but stagnation in skilled nursing facilities. ...

CMS releases RFI to overhaul Medicare claims system Inside Health Policy; by Jalen Brown; 1/9/26 CMS unveiled a request for information (RFI) Thursday (Jan. 8) aimed at replacing Medicare’s decades-old claims processing system with a modern, cloud-based platform that would be capable of adjudicating millions of claims per day in real time, which would fundamentally re-architect how Medicare pays providers. In Thursday’s RFI, dubbed “ClaimsCore,” CMS is asking large-scale technology vendors to demonstrate whether they can operate a full Medicare claims adjudication system inside a CMS-owned Amazon Web Services cloud environment.

US Department of Justice and Dr. Oz targeting California over alleged medical fraud  ABC-7 Los Angeles, CA; by Anabel Munoz The Department of Justice is investigating what it's calling medical fraud in California. First Assistant U.S. Attorney Bill Essayli and Dr. Mehmet Oz held a brief news conference in Los Angeles on Friday to say they're targeting the state of California over the alleged fraud. ... "The patients don't realize they're signing up for hospice, so they're giving up their medical ability to take care of themselves. They're moving outside the health care system, where doctors no longer will care for them because they're in hospice," Oz said. 

NPHI organizes listening tour on hospice program integrity with CMS leaders Dr. Oz and Kim BrandtNational Partnership for Healthcare and Hospice Innovation (NPHI); Press Release; 1/8/26On Thursday [1/9], Dr. Mehmet Oz, Administrator of the Centers for Medicare & Medicaid Services (CMS), and Kim Brandt, CMS Chief Operating Officer ... are visiting Nathan Adelson Hospice in Las Vegas as part of a listening session and on-site tour. On Friday, the tour continues in California, where NPHI is supporting discussions with federal leaders and providers in the state focused on fraud and abuse challenges impacting hospice care. These conversations are intended to help federal leaders better understand what providers are seeing on the ground and explore how CMS and the provider community can work together to strengthen program integrity while protecting access to high-quality, mission-driven care.

Dying with dignity - personal perspective: The sacred ending we don’t talk about enough. Psychology Today; by Cynthia Chen-Joea DO, MPH, FAAFP, DABOM; 12/24/25 In the U.S., we spend enormous amounts of energy keeping people alive, curing, fixing, and prolonging life at all costs. What we rarely talk about is how people die. And more importantly, how poorly our system supports them when the end is clearly approaching. ... [Background story about her dad's Parkinson's and eventual death] ... Then came our request for hospice. After an evaluation, we were told he didn’t “qualify” because he had gained some weight and his albumin levels were “too high.” An arbitrary checklist, based on labs values, prevented him from getting into hospice. [Keep reading] So we tried for palliative care instead. I made call after call, only to be bounced between departments, many unclear on the difference between hospice and palliative care, ... Even as a physician, I was stunned by how many barriers we encountered simply trying to do the most humane thing: to advocate for dignity, comfort, and respect at the end of my father’s life.

Hospice: Care, commerce, and the cost of a separate category The Pine Belt News, Hattiesburg, MS; by Cathy Eaker; 1/5/26 Hospice care is often presented as a compassionate alternative to aggressive medicine—a gentler path that prioritizes comfort, dignity, and peace at the end of life. In theory, it is a humane model. In practice, hospice exists at the intersection of care and commerce, and that intersection deserves far more scrutiny than it receives. ... That does not mean hospice nurses, aides, social workers, or chaplains are unethical. Quite the opposite. Most of the people providing hands-on hospice care have good hearts. They care deeply. They show up. They bathe patients gently, sit at bedsides, hold hands, and witness grief with humanity. The problem is not the caregivers—it is the structure they work within. ...

Fourth temporary extension of COVID-19 telemedicine flexibilities for prescription of controlled medications Federal Register - The Daily Journal of the United States Government; A Rule by the Drug Enforcement Administration and the Health and Human Services Department on 12/31/2025 AGENCY: Drug Enforcement Administration, Department of Justice; Substance Abuse and Mental Health Services Administration, Department of Health and Human Services. ACTION: Temporary rule. SUMMARY: The Drug Enforcement Administration (DEA) jointly with the Department of Health and Human Services (HHS) is issuing a fourth extension of telemedicine flexibilities for the prescribing of controlled medications through December 31, 2026. DATES: This rule is effective January 1, 2026 through December 31, 2026.

Hospice care for medicaid cancer patients in Puerto Rico: implications on healthcare costs and utilization JNCI Cancer Spectrum; by Karen J Ortiz-Ortiz, Marjorie Vázquez-Roldán, Axel Gierbolini-Bermúdez, María Ramos-Fernández, Carlos R Torres-Cintrón, Yisel Pagán-Santana, Tonatiuh Suárez-Ramos, Kalyani Sonawane; 12/27/25 Online ahead of print Background: ... In Puerto Rico, Medicaid had no provisions for hospice care until July 2024, representing a significant public health challenge. This study examined the association between hospice coverage policy and EoL outcomes among patients with cancer enrolled in Medicaid.Conclusion: Hospice enrollment among Medicaid enrollees was associated with lower health expenditure, lower healthcare resource utilization, and a lower likelihood of mortality in an acute setting. The recent policy change to include hospice services coverage in Puerto Rico Medicaid is a positive step that must be sustained beyond 2027.

Medicare Final Rule changes that home health providers need to know Home Health Care News; by Morgan Gonzales; 12/17/25 The Medicare home health final payment rule for calendar year 2026 has been most discussed for its methodology and its 1.3% aggregate rate cut, but other aspects of the final rule require home health providers to carefully strategize for the upcoming year. ... In 2026, it will be key for providers to determine their case-mix weights and how to work with different PDGM groups, according to Cindy Campbell, senior director of advisory services at WellSky.