Facts and Figures: 2025 Edition

Background and Methodology

The National Alliance for Care at Home, in collaboration with the Research Institute for Home Care, presents the 2025 edition of Facts and Figures – the leading resource on hospice care delivery in the United States. Published annually for over two decades, this report provides comprehensive data on patient characteristics, care settings, Medicare spending, provider information, and quality measures. 

This edition reflects care provided in calendar year 2024 by hospices certified by the Centers for Medicare & Medicaid Services (CMS) and reimbursed under the Medicare Hospice Benefit. Through enhanced collaboration with the Research Institute for Home Care, this report features new data sources that provide more current information than previously available. The report includes a special focus on quality reporting and measurement within the hospice payment system. 

Key Findings: Record Growth in Hospice Utilization

Overall Enrollment Continues to Grow 

In 2024, 1.91 million Medicare beneficiaries were enrolled in hospice care for one or more days, representing a 4.4% increase from 2023. Of these enrollees, 1.3 million died while in hospice care. 

Historic Milestone: Majority of Medicare Decedents Now Use Hospice 

For the first time, 53.1% of all Medicare decedents in 2024 received hospice care and were enrolled at the time of death. This marks the third consecutive year of increases and surpasses pre-pandemic levels, demonstrating significant progress toward enabling access to hospice for all eligible terminally-ill Medicare beneficiaries. 

Principal Diagnoses Reflect Diverse Terminal Conditions 

Circulatory conditions were the most common principal diagnosis (29.8% of hospice stays), followed by neurovascular conditions (25.4%) and cancer (22.3%). Together with respiratory conditions (10.1%) and kidney disease (3.0%), these five condition groups account for over 90% of all hospice stays. 

Medicare Advantage Transition Patterns Continue 

Medicare Advantage (MA) continued to cover a larger portion of the Medicare population in 2024. MA beneficiaries typically transition to Traditional Medicare to access the Medicare Hospice Benefit. A demonstration program that ran from 2021-2024 to test whether MA plans could effectively cover hospice was ended early due to low participation and technical challenges. 

Significance for Policy and Practice

The 2024 data demonstrate patient-preference for care at home and continued momentum in expanding access to hospice, with a historic majority of Medicare decedents now receiving these services. As payment and regulatory policies have returned to a non-emergency state following the COVID-19 pandemic, the hospice sector shows resilience and continued growth in serving America’s terminally ill population, serving as part of the solution to improving the U.S. healthcare system. 

For media inquiries or additional information, please contact the National Alliance for Care at Home at communications@allianceforcareathome.org.