The Medicare Payment Advisory Commission (MedPAC) on September 5, as part of an ongoing special project, updated commissioners on research and analysis around hospice access for end-stage renal disease (ESRD) patients and cancer patients.

Specifically, the special project examines how lack of incentives in the hospice payment system to provide palliative treatments like dialysis impact beneficiary access to hospice services and whether  the payment system needs to change to address these barriers.

Initial findings were shared at the April 2025 commission meeting and the final report will be published in the June 2026 Report to Congress.

Based on the April 2025 conversation with commissioners, MedPAC staff shared new research on drugs furnished to hospice patients and offered an analysis of hospice payments to estimated cost for selected services. MedPAC also offered three potential policy directions for commissioners to consider in order to improve access to specialized services. These include enhanced data reporting, hospice policy payment changes of either an outlier or add-on or case mix adjustments, or a voluntary transitional program.