Literature Review

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. 

False Claims Act insights - the rise of state False Claims Act enforcement Husch Blackwell | Thought Leadership; podcast hosted by Jonathan Porter with Rebecca Furdek and Todd Gee; 1/12/26 Our conversation starts with an overview of state False Claims Acts and how the use of FCA varies from state to state. We examine recent settlements in Massachusetts and Minnesota that show the reach of state False Claims Acts and discuss a large District of Columbia False Claims Act settlement for tax liability that could be the next big enforcement area for state-level False Claims Acts.

Medicare Advantage overpayments will total $76B this year: MedPAC Healthcare Dive; by Rebecca Pifer Parduhn; 1/16/26 The federal government will pay an estimated $76 billion more to cover Medicare Advantage seniors this year than it would if those same seniors were in traditional Medicare, according to new estimates from an influential advisory group. ... Still, the report released [1/16] Friday by the Medicare Payment Advisory Commission is likely to add more fuel to concerns about overpayments in the privatized Medicare program, which has grown to cover more than half of all Medicare enrollees.

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.

New AMA survey spotlights top priorities, challenges in 2026 HCN - HealthCare News, Chicago, IL; by HCN Staff; 1/9/26 Physician organizations are preparing for a dynamic state legislative landscape this year with health policy changes poised to reshape coverage, oversight, care delivery, and public health across the health system, according to a new survey released by the American Medical Assoc. (AMA). The AMA’s survey of 64 medical societies, including all 50 state medical societies and the District of Columbia, spotlights the leading healthcare priorities and challenges set to define state-level legislative action in 2026. Top issues include scope of practice, Medicaid policy pressures, and physician workforce challenges.

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.