Alliance Comments on MedPAC’s Medicare Recommendations for 2025

ALEXANDRIA, Virginia & WASHINGTON—The National Alliance for Care at Home (the Alliance) released the following statement on the Medicare Payment Advisory Commission’s (MedPAC) March 2025 Report to Congress: Medicare Payment Policy. MedPAC’s congressionally mandated report provides analysis and recommendations on various Medicare programs, including home health and hospice. The Commission’s findings focus on payment adequacy, access to care, quality, financial performance and projections for 2025 and beyond. The Alliance covered the December 2024 meeting discussing MedPAC’s recommendations as well as the January 2025 meeting finalizing its recommendations.  

Alliance CEO Dr. Steve Landers made the following comment in response to the recommendations:

“MedPAC’s recommendations are based on flawed and incomplete analyses with conclusions unsupported by all the available facts. These recommendations severely undervalue the critical role that home health and hospice providers play in ensuring the health and well-being of Medicare beneficiaries. Recommending unthinkable cuts for home health and stagnant payment rates for hospice in the face of workforce shortages and inflation threaten access to these vital services for our aging population and undermine the dedicated providers who support them. We know that earlier access to hospice improves the end-of-life experience for patients and families and saves the system money. 

“Timely access to home health is a life and death issue; mortality rates are higher when home health referrals go unfilled. We call on MedPAC to develop a more reliable proxy for determining access to care. Telling Congress that access to home health services is ‘adequate’ based solely on the mere presence of an agency within a zip code does not align with what health systems are finding when trying to refer patients to home health care. 

“Care at home is preferred by patients and helps save Medicare resources by avoiding costly and unnecessary hospitalization and institutionalization. MedPAC’s recommendations are dangerous and would take Medicare policy in the exactly wrong direction. Strategic investment in expanding hospice and home health services would yield far greater long-term benefits than the shortsighted funding restrictions currently proposed.

“The Alliance remains firmly committed to communicating with MedPAC commissioners and staff to ensure they understand the critical challenges facing care-at-home providers and the real-world impact of their recommendations. The Alliance supports home-based care precisely because it represents a rare policy solution benefiting both patients and taxpayers. If implemented, MedPAC’s proposed cuts would ultimately increase federal health expenditures rather than generate the savings they aim to achieve.” 

In the report, MedPAC shared the following recommendations: 

• Home Health: Final recommendation: For calendar year 2026, Congress should reduce the 2025 Medicare base payment rates for home health care services by 7%. 
• Hospice: Final recommendation: For fiscal year 2026, Congress should eliminate the update to the 2025 Medicare base payment rates for hospice. 

MedPAC serves as an advisory body to Congress and its recommendations—even if unanimously approved—require legislative action to be implemented. While non-binding, these recommendations influence critical policy decisions that affect patient access and provider sustainability.