06/23/2026

GAO Examines Hospice Payment Structure; Raises Questions About Future Payment Design

A new Government Accountability Office (GAO) report is generating discussion across the hospice community after examining variation in routine home care visit patterns and modeling how Medicare hospice payment may perform under alternative reimbursement approaches.

While the report estimates potential savings under hypothetical payment structures, no payment changes have been proposed or adopted at this time.

Why it matters:
Even without immediate policy change, this report reflects broader trends providers are already seeing nationally, increased focus on program integrity, value demonstration, visit intensity, and closer examination of how payment aligns with services delivered and patient complexity.

What to do:

• Review your organization’s visit patterns and care intensity trends to understand your current delivery model.
• Evaluate whether documentation and operational data clearly reflect patient complexity and interdisciplinary care provided.
• Consider how your organization would explain the value of hospice services beyond visit counts alone.
• Watch for future discussions at the federal level as payment reform conversations continue to evolve. 

Current hospice reimbursement remains unchanged, and any structural changes would require Congressional action. LeadingAge National plans to continue discussion on this topic during the July Hospice Member Network and is encouraging providers to reflect on how the findings compare to their own operational experience.