(Alexandria VA) — The National Alliance for Care at Home (the Alliance) today responded to the Centers for Medicare & Medicaid Services (CMS) Fiscal Year (FY) 2027 Hospice Wage Index proposed rule, which proposes payment and regulatory updates under the Medicare hospice benefit.
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, including new analyses of non-hospice spending and the introduction of a hospice service and spending variation index (SSVI). CMS is proposing that hospices be required to provide the hospice election statement addendum to all Medicare beneficiaries at the time of hospice election beginning on or after October 1, 2026. CMS also proposes adding an icon to the Medicare.gov Compare Tool as part of the Hospice Quality Reporting Program (HQRP). While we are supportive of efforts to strengthen program integrity, it is critical that policies reflect the clinical complexity of end-of-life care and avoid unintended consequences that could disrupt access to hospice services or create unnecessary burden for legitimate providers.
“Hospice care is an invaluable part of the Medicare program, with evidence demonstrating that it is the preferred choice by patients and families when appropriate. While a 2.4% payment increase is a step in the right direction, more must be done to ensure that high-quality providers have the resources they need to operate in this demanding environment,” said Jennifer Sheets, CEO of the Alliance. “The Alliance appreciates the increased oversight and transparency proposals but calls on CMS to carefully implement these measures to avoid unintended consequences for patients and providers. We must protect this essential service so every American can receive compassionate, dignified care at the end of life.”
The Alliance is committed to working with CMS on solutions that fortify and expand the Medicare hospice benefit. The Alliance also continues to support the agency’s focus on addressing fraud, waste, and abuse through targeted, data-driven strategies that protect patients and legitimate providers without compromising access to high-quality, person-centered care.
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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.
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National Alliance for Care at Home
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Hannah Kristan | 202-355-1647