The Medicare Payment Advisory Commission (MedPAC) on December 5, 2025 provided a draft payment update recommendations for home health and hospice.

For home health, citing continued high fee for service (FFS) margins, MedPAC reiterated its recommendation to cut home health Medicare payments by 7%, a position LeadingAge strongly disagrees with and opposes.

For hospice, MedPAC recommended an elimination of the Medicare payment update—so a 0% change.

LeadingAge also opposes this recommendation understanding that our members’ costs already exceed the payment update they are receiving.

LeadingAge reminds members that MedPAC payment recommendations are advice to Congress but are not binding. Congress would have to enact specific recommendations in order for them to take effect.

In addition to the yearly update discussion, MedPAC provided an update on their forthcoming mandatory report on the transition to PDGM. The final report will be included in the March 2026 report.

The key findings of the analysis presented were:

1) PDGM didn’t have much effect on home health utilization;

2) There were fewer visits in home health under PDGM but with little to no quality changes, and

3) There is a higher FFS payment to cost ratio under PDGM.

Another report out on this work will be issued at the January meeting prior to the report’s final release in March.