A new federal report is putting the Medicare hospice payment model back in the spotlight and could shape future conversations about reimbursement, program integrity, and how care delivered in the home is evaluated.
On June 9, the Government Accountability Office (GAO) released a report examining routine home care payments under the Medicare hospice benefit and suggested Congress consider directing HHS to evaluate whether payment approaches could better align with services delivered.
The report reviewed variation in routine home care visit frequency across hospices and found meaningful differences in visit intensity between providers. GAO also compared hospice payment assumptions to adjusted home health style per visit reimbursement models and estimated Medicare spending may have differed under an alternative structure.
At the same time, provider organizations urged caution in interpreting the findings. National leaders noted that many of the low visit patterns highlighted in the report appear concentrated in markets already associated with fraud concerns and emphasized that hospice and home health operate under different benefit structures, regulatory requirements, staffing models, and patient goals.
While the report focused on hospice, it also sparked broader discussion across care at home because of the use of home health comparisons.
This report does not change reimbursement today. Any significant changes would require additional federal review and likely congressional action.
Why it matters
Providers should expect continued attention on:
For home health providers, this also serves as a reminder that policymakers increasingly evaluate care models across settings and may look at cross sector comparisons when shaping future policy.
What to do
Bottom line:
No payment changes are happening today, but this report may offer an early signal of where future hospice and care at home policy conversations are headed.