Rural Health
Resources by Topic: Hospice and palliative care
MedPAC Payment Basics
Series of briefs providing an of Medicare payment systems. Covers payments systems including Accountable Care Organizations (ACO), Critical Access Hospitals (CAH), Federally Qualified Health Centers and Rural Health Clinics, hospital acute inpatient services, and more.
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Series of briefs providing an of Medicare payment systems. Covers payments systems including Accountable Care Organizations (ACO), Critical Access Hospitals (CAH), Federally Qualified Health Centers and Rural Health Clinics, hospital acute inpatient services, and more.
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Hospice Services Payment System
Overview of the Medicare hospice benefit and Medicare payments to hospice providers. Describes the four levels of care of the hospice prospective payment system and payment rates.
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Overview of the Medicare hospice benefit and Medicare payments to hospice providers. Describes the four levels of care of the hospice prospective payment system and payment rates.
Date: 10/2026
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Comment on CMS's Proposed Rule on the Payment System for End-Stage Renal Disease for CY 2027
Comments on a June 26, 2026, Federal Register proposed rule related to Medicare payment policies for end-stage renal disease (ESRD). Includes comments addressing updates to the ESRD bundled market basket and the low-volume payment adjustment (LVPA), approaches to increase home dialysis use, and more.
Date: 08/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a June 26, 2026, Federal Register proposed rule related to Medicare payment policies for end-stage renal disease (ESRD). Includes comments addressing updates to the ESRD bundled market basket and the low-volume payment adjustment (LVPA), approaches to increase home dialysis use, and more.
Date: 08/2026
Sponsoring organization: Medicare Payment Advisory Commission
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MedPAC Data Book: Health Care Spending and the Medicare Program, 2026
Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural-specific provider sites, as they relate to spending, access to care, and Medicare and operating margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures and Rural Emergency Hospital conversions.
Date: 07/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural-specific provider sites, as they relate to spending, access to care, and Medicare and operating margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures and Rural Emergency Hospital conversions.
Date: 07/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Feasibility and Acceptability of a Rural Palliative Care Intervention for Patients with Heart Failure (RuPAL-HF)
Evaluates the feasibility and acceptability of a collaborative palliative care model among 13 patients with heart failure receiving care at a primary care clinic in rural Maine. Covers topics including staff training outcomes, telehealth use, and the facilitators of end-of-life conversations, planning documents, and more.
Author(s): Francesca X. Piccolo, Eric C. Anderson, Hanna Gutow, et al.
Citation: BMC Palliative Care, 25, 245
Date: 06/2026
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Evaluates the feasibility and acceptability of a collaborative palliative care model among 13 patients with heart failure receiving care at a primary care clinic in rural Maine. Covers topics including staff training outcomes, telehealth use, and the facilitators of end-of-life conversations, planning documents, and more.
Author(s): Francesca X. Piccolo, Eric C. Anderson, Hanna Gutow, et al.
Citation: BMC Palliative Care, 25, 245
Date: 06/2026
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MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2026
Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers payment incentives in Medicare, the complexity of Medicare enrollment decisions for beneficiaries, Medicare payment operations and their role in identifying improper payments, the estimated association between Medicare Advantage (MA) enrollment and hospitals' and post-acute care providers' finances, and access to hospice and certain complex palliative services for beneficiaries with end-stage renal disease or cancer. Includes a mandated report regarding the Medicare Ground Ambulance Data Collection System. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers payment incentives in Medicare, the complexity of Medicare enrollment decisions for beneficiaries, Medicare payment operations and their role in identifying improper payments, the estimated association between Medicare Advantage (MA) enrollment and hospitals' and post-acute care providers' finances, and access to hospice and certain complex palliative services for beneficiaries with end-stage renal disease or cancer. Includes a mandated report regarding the Medicare Ground Ambulance Data Collection System. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Hospice: Action Needed to Pay More Efficiently for Routine Home Care
Describes the frequency and characteristics of routine home care visits in 2024 for Medicare beneficiaries enrolled in hospice since 2022 who died or were discharged alive in 2024. Compares estimated per-visit Medicare payment rates for routine home care across hospices with the highest and lowest number of visits per week and to home health per-visit rates. Includes information on the average number of visits per week by rural and urban hospice providers. Offers recommendations to the U.S. Department of Health and Human Services regarding revisions to the hospice payment system.
Additional links: Full Report
Date: 06/2026
Sponsoring organization: Government Accountability Office
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Describes the frequency and characteristics of routine home care visits in 2024 for Medicare beneficiaries enrolled in hospice since 2022 who died or were discharged alive in 2024. Compares estimated per-visit Medicare payment rates for routine home care across hospices with the highest and lowest number of visits per week and to home health per-visit rates. Includes information on the average number of visits per week by rural and urban hospice providers. Offers recommendations to the U.S. Department of Health and Human Services regarding revisions to the hospice payment system.
Additional links: Full Report
Date: 06/2026
Sponsoring organization: Government Accountability Office
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"If I Have Any Problems, I Just Want to See My [Primary Care] Doctor": Perspectives on a Proposed Collaborative RUral PALliative Care Intervention (RuPal)
Explores perspectives on a proposed palliative care intervention among 26 heart failure patients, caregivers, and primary care providers in rural Maine. Discusses perspectives on trust in primary care versus specialist-delivered palliative care and facilitators of effective palliative care collaborations.
Author(s): Eric C. Anderson, Susan DeSanto-Madeya, Nicole Hudak, et al.
Citation: BMC Palliative Care, 25, 199
Date: 05/2026
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Explores perspectives on a proposed palliative care intervention among 26 heart failure patients, caregivers, and primary care providers in rural Maine. Discusses perspectives on trust in primary care versus specialist-delivered palliative care and facilitators of effective palliative care collaborations.
Author(s): Eric C. Anderson, Susan DeSanto-Madeya, Nicole Hudak, et al.
Citation: BMC Palliative Care, 25, 199
Date: 05/2026
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MedPAC Report to the Congress: Medicare Payment Policy: Hospice Services: Chapter 10
Discusses payment adequacy for hospice and palliative support services. Includes data on average costs by day and aggregate margins by urban and rural status, as well as demographics on Medicare decedents who used hospice during 2010 and between 2019-2024. Compares the actual hospice utilization rates in micropolitan, rural adjacent, rural nonadjacent, and frontier areas to urban hospice utilization rates.
Date: 03/2026
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Discusses payment adequacy for hospice and palliative support services. Includes data on average costs by day and aggregate margins by urban and rural status, as well as demographics on Medicare decedents who used hospice during 2010 and between 2019-2024. Compares the actual hospice utilization rates in micropolitan, rural adjacent, rural nonadjacent, and frontier areas to urban hospice utilization rates.
Date: 03/2026
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MedPAC Report to the Congress: Medicare Payment Policy, 2026
Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for Medicare fee-for-service payment systems, Medicare Advantage (MA), and Medicare Part D. Includes mandated reports on the impact of regulatory changes to the home health prospective payment system and dual-eligible special needs plans.
Date: 03/2026
Sponsoring organization: Medicare Payment Advisory Commission
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Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for Medicare fee-for-service payment systems, Medicare Advantage (MA), and Medicare Part D. Includes mandated reports on the impact of regulatory changes to the home health prospective payment system and dual-eligible special needs plans.
Date: 03/2026
Sponsoring organization: Medicare Payment Advisory Commission
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