The Government Accountability Office (GAO) released on June 9, 2026, a report entitled Medicare Hospice: Action Needed to Pay More Efficiently for Routine Home Care. The report covers the frequency of hospice routine home care visits and how estimated per-visit payment rates for hospice routine home care compare across selected hospices as well as to home health per-visit payment rates.

The report divides hospices into quintiles based on visits with the lowest quintile (“low visit hospices”) averaging 2.5 visits per beneficiary per week and the highest quintile (high visit hospices) averaging 5.5 visits per beneficiary per week. The report concludes that because Medicare’s hospice daily payment rates are the same regardless of the number of visits delivered, Medicare effectively paid low-visit hospices twice as much per visit as high-visit hospices, on average. GAO also concluded that Medicare effectively paid more per visit under hospice payment rates than it would have under rates for comparable home health visits.

LeadingAge generally supports hospice payment reform but has not taken a position on whether a per visit model for routine home care is the best path forward. LeadingAge is still reviewing the details and methodology of report and will write a comprehensive summary in the coming days.

LeadingAge will also use the July Hospice Member Network meeting to dive into this issue in more detail with members and asks that hospice members read the report and come prepared to discuss how what GAO prepared aligns or does not align with their experience and cost profile.