Home-based Hospice Providers Face Proposed 2.4% Increase That ‘barely Keeps Up With Inflation’

The Centers for Medicare & Medicaid Services (CMS) has proposed a 2.4% bump in payments to hospices in 2027, an increase that home-based care advocacy organizations said will create challenges for providers.

CMS estimates the proposed 2.4% rate increase would deliver an additional $785 million in hospice payments in 2027 compared to 2026. The National Alliance for Care at Home and LeadingAge both called the rule’s adequacy into question. 

“The rule’s proposed payment rate update of 2.4% barely keeps up with inflation,” Linda Couch, the senior vice president of policy at LeadingAge, said in a statement. “Payment that scarcely covers the cost of services delivered threatens the ability of quality-focused, mission-driven providers to deliver needed care and potentially limits access for those who seek it.”

The Alliance said that hospice providers, which have faced years of challenges including inflation, staff shortages and rising costs, will still face difficulties following a potential 2.4% rate increase.

“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,” Jennifer Sheets, CEO of the Alliance, said in a statement. “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.”

In addition to the 2.4% increase, the proposed rule included other measures, such as transparency measures and changes to regulations and quality programs. LeadingAge voiced its support for increased transparency as part of CMS’ work on program integrity.

The Alliance has also voiced its support when it comes to eliminating fraud, waste and abuse from the Medicare benefit. In its statement regarding the proposed rule, the organization did specify that “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.”

Additionally, CMS decided to grant a waiver to all Hospice Outcomes and Patient Evaluation (HOPE) assessments dated Oct. 1, 2025, to Dec. 31, 2025, and consider them timely, a move that LeadingAge said it was “incredibly grateful” for.

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