Study finds hospice providers “game” Medicare Payment Cap, but with modest impact on costs

Study finds hospice providers “game” Medicare Payment Cap, but with modest impact on costs 
Penn LDI - Leonard Davis Institute of Health Economics; by Julia Hinkcley, JD; 9/16/25 
... Each year, about half of Medicare beneficiaries who die receive hospice services. A new study by LDI Senior Fellow and Director of Research Norma Coe and her colleague David Rosenkranz shows that some hospice agency decision-making may be intended to increase payments by undercutting the annual revenue cap that Medicare imposes. But this “gaming” of the payment rules creates only modest increases in both hospice enrollment and spending. The study’s findings also support MedPAC’s view that wage index-adjusting the cap could make it more equitable across hospice programs, but the authors caution that the MedPAC proposal to reduce the cap by 20 percent might lead some hospice providers to close, and therefore requires more analysis.