# The 2026 National Hospice Study 2026 National Hospice Study | Astrelis State of the Industry Built on 2024 federal data and current 2026 policy. The national averages describe two industries at once. Page: https://astrelis.co/studies/hospice/2026 This twin: https://astrelis.co/studies/hospice/2026.md Edition: 2026 Published: 2026-07-19 (revised 2026-07-20) Author: Matt Borchardt, Founder, Astrelis Release: 2321a4fc37a7 (2026-10-22) ## Data vintage This 2026 edition stands on 2023 and 2024 federal reporting cycles, current FY2026 policy, preliminary FY2025 labeled. - Published July 2026 ยท Version 2.0 - Data: 2023 and 2024 federal reporting cycles, current FY2026 policy, preliminary FY2025 labeled - Sources: MedPAC, CMS, the Hospice Monitoring Reports, HHS OIG - Analytic universe: 6,706 (Hospice) ## Headline findings, as printed 1. **The growth is all one kind** The hospice count grew about 64 percent in a decade. The decade's growth was almost entirely for-profit while nonprofit and government supply contracted. The provider count: 6,706. 82% for-profit in 2024 2. **The average margin belongs to no one** For-profit hospices earned 13.7 percent on Medicare in 2023. Nonprofit hospices earned negative 1.3 percent. The 8.0 percent aggregate is a policy-level measure, not the margin of a typical hospice. The two margins: 8.0%. an average of 13.7 and negative 1.3 3. **The only benefit with a ceiling** Hospice is the only Medicare fee-for-service benefit with a provider-level aggregate payment cap calculated from a per-beneficiary amount, and 28 percent of hospices went through it in 2023. The aggregate cap: 28%. exceeded the $35,361.44 ceiling 4. **The crisis-capacity question** Routine home care is 98.8 percent of hospice days. One patient in six still touches a higher level of care. Levels of care: 98.8%. of days, one level; 16% of patients touch GIP 5. **The last three days** Fewer than half of hospice patients get a nurse or social-worker visit in their final days. The last three days: 48.3%. national HVLDL, deciles 21 to 81 6. **The discharge that is not a death** Almost one in five hospice discharges is a patient leaving alive, and the rate is climbing. Live discharge: 19.1%. preliminary FY2025, broad basis 7. **The two-patient problem** A cancer patient stays 51 days. A dementia patient stays 164. The mix decides the economics. Patient mix: 51 vs 164. days, cancer vs dementia 8. **The two-tail problem** One hospice stay in five lasts four days or less. One in six lasts more than half a year. The two tails: 20.4 / 17.6. percent of stays, 1 to 4 days / 181 plus 9. **CMS already has a score on you** In April 2026, CMS published a program-integrity score for every hospice, by name, built from nine claims measures. The federal score: 0 to 16. SSVI, published by CCN ## The nine numbers from this study worth carrying into your next board meeting - 82 percent: Share of the 6,706 hospices that were for-profit in 2024, up from about 63 percent in 2014. The decade's growth was almost entirely for-profit while nonprofit and government supply contracted, and since May 13, 2026 a nationwide moratorium has closed enrollment to new hospices. - 13.7 vs negative 1.3: For-profit versus nonprofit Medicare hospice margin in 2023. Structure and scale cut deeper still: freestanding 10.2, hospital-based negative 25.6, lowest-volume fifth negative 20.2, highest-volume fifth 9.5. - 28 percent: Share of hospices that exceeded Medicare's aggregate cap in 2023, up from 19 percent in 2020. Outside Arizona, California, Nevada, and Texas it is about 6 percent. - 98.8 and 16: Routine home care's share of hospice days, and the share of patients who nonetheless received at least one general inpatient day. Two denominators, one crisis-capacity question. - 48.3 percent: National HVLDL: the share of hospice patients who got an RN or social-worker visit on at least two of their final three days. Bottom-decile hospices, about 21 percent; top-decile, about 81 percent. - 19.1 percent: Live-discharge rate on preliminary fiscal 2025 claims, up from 16.9 percent in fiscal 2021 on the same basis. Late live discharges are 37.4 percent of live discharges nationally. - 51 vs 164: Average length of stay in days, cancer versus dementia and neurological. Mix drives stay length, cap exposure, and margin. - 20.4 and 17.6: The two tails, on preliminary fiscal 2025 claims: the share of stays lasting 1 to 4 days, and the share lasting 181 days or longer. The average conceals the shape. - 0 to 16: The range of the SSVI, the provider-level score CMS published in April 2026 for every hospice, by name, from nine claims measures. The regulator stopped looking only at the average. ## Sources Every figure is attributed in the text to its originating source; the full source list is the study's appendix on the page. Print layout (PDF): https://astrelis.co/research/2026-national-hospice-industry-study-astrelis.pdf. Also in the series: https://astrelis.co/studies ## Cite Astrelis, "The 2026 National Hospice Study" (2026 edition), https://astrelis.co/studies/hospice/2026, published 2026-07-19; release 2321a4fc37a7 (2026-10-22). Figures are as published by the named sources and were not audited by Astrelis. Astrelis is not a CPA firm and performs no audit, review or attestation of any facility.