(Alexandria, VA and Washington, DC) – The 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.
MedPAC’s recommendations would significantly reduce home health payment rates by 7% for calendar year 2027 and eliminate payment updates for hospice care in fiscal year 2027. If implemented, these actions would further reduce access to care for vulnerable populations, at a time where demand for care at home is increasing.
The Alliance has continued to voice concerns with MedPAC’s misguided recommendation since its January vote. In early January, the Alliance submitted a letter to MedPAC, emphasizing dangerous implications with these payment recommendations, particularly amidst a growing workforce crisis. The letter states, “recommendations to reduce the home health payment rates and to provide no payment updates for hospice care risk undermining provider capacity and patient access to services that are demonstrably cost-effective, align with patient and family preferences, and contribute to lower overall Medicare program spending.”
“MedPAC’s recommendation is dangerous and misguided, and would exacerbate a growing access crisis for care in the home. We know that cumulative year-after-year payment cuts have forced home health agencies to narrow service offerings, reduce service areas, and, at worst, close altogether. Last year, we saw CMS make adjustments to the Home Health Prospective Payment System (HH PPS) Final Rule for CY 2026 that appeared to signal concerns about access to care. However, we once again find ourselves facing recommended payment cuts that do not align with the operating reality for providers. Something must change.” said Jennifer Sheets, CEO of the Alliance.
“MedPAC’s recommendation to eliminate the hospice payment update in FY 2027 is deeply concerning for the providers, patients, and families who rely on this essential benefit. While there is no room for fraud, waste, and abuse in hospice, the conduct of fraudulent actors should not be used to characterize an entire field dedicated to compassionate end-of-life care. Hospice has long demonstrated its value — improving patient and family satisfaction, saving Medicare money, and helping deliver high-quality care in the setting people overwhelmingly prefer: their homes. Policymakers should focus on strengthening and protecting access to hospice, not implementing policies that could unintentionally limit care for patients.”
The Alliance is dedicated to advancing policies that support care at home for millions of Americans at all stages of life, including sustainable payment policy that supports patient access to care and targeted oversight to root out bad actors. We look forward to continued engagement with MedPAC and Congress to ensure the Commission fully recognizes the value home health and hospice bring to patients, families, and the Medicare program.
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About the National Alliance for Care at Home
The National Alliance for Care at Home (the Alliance) is the leading authority in transforming care in the home. As an inclusive thought leader, advocate, educator, and convener, we serve as the unifying voice for providers and recipients of home care, home health, hospice, palliative care, and Medicaid home and community-based services throughout all stages of life. Learn more at www.AllianceForCareAtHome.org.
Press Contact
communications@allianceforcareathome.org
Hannah Kristan | 202-355-1647