Five-day shift in timing could generate substantial savings while improving end-of-life care
(Alexandria, VA) – 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 $1.50 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.
The project’s Early Hospice Election Model analyzed Medicare beneficiaries who enrolled in hospice within eight weeks of death. Using data from rigorous, peer-reviewed studies spanning between 2002 and 2018, researchers concluded that repeated earlier hospice elections generate incremental daily savings that compound over time.
“The implications of this study further underscore what the hospice community has long understood and recent research has revealed: timely hospice care not only represents the preferred choice for patients and families, but also presents sound fiscal policy,” said Jennifer Sheets, CEO for the Alliance and President of the Institute. “The potential savings identified in this report are further evidence of the additional value hospice can add to the Medicare program while ensuring more compassionate, person-centered care is provided for Americans at the end of life.”
The ATI analysis follows other recently released data underscoring the value of hospice care in America, including the 2025 Hospice Chartbook. According to the Chartbook, 31% of hospice stays are a week or less, and 26% were eight to 30 days, signaling an opportunity for families to elect hospice sooner. Further, according to the new Alliance Facts & Figures Report, of all Medicare decedents in CY 2024, 53.1% received at least one day of hospice care and were enrolled in hospice at the time of death, underscoring the scope of the savings potential identified in the ATI analysis.
Hospice care plays a critical role in improving end-of-life care, increasing patient and caregiver satisfaction while reducing unnecessary hospital stays and ICU deaths. Further, studies repeatedly show patients with terminal prognoses would prefer earlier hospice election.
The Institute and the Alliance remain dedicated to working together to engage with providers, policymakers, and the public to build a greater understanding of potential cost savings and improvements to the Medicare hospice benefit, and to advance evidence-based approaches to end-of-life care reform and advance care planning.
Opportunities to Learn More
The complete analysis and methodology are available in the full report.
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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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