The FY 2026 Hospice Final Rule, released by the Centers for Medicare & Medicaid Services (CMS), includes a 2.6% payment increase for hospice providers beginning October 1, 2025. While an improvement over the 2.4% initially proposed, many, including the National Alliance for Care at Home, caution that this increase still does not reflect the true costs of providing hospice care in today’s economic climate.
With labor, benefits, supply, and travel expenses continuing to rise at rates well above the payment adjustment, hospice agencies will need to navigate mounting pressures on their ability to recruit, retain, and support their workforce.
At Viventium, we understand that sustaining a skilled, stable team is the foundation of quality hospice care. Payment policies are more than just numbers. They shape the real-world capacity of agencies to keep their people, maintain service quality, and meet growing community needs.
A raise that falls short of costs
While the updated payment rate is a step in the right direction, provider labor costs have consistently risen over 4% annually in recent years. For agencies already stretched thin, the 2.6% boost still leaves a gap that can force difficult decisions such as slowing recruitment, limiting patient admissions, cutting benefits, or reducing hours.
In hospice care, where continuity and relationships are central, even small disruptions to staffing can have a direct impact on patient and family experiences.
The squeeze on hospice staffing
Hospice agencies face the same workforce challenges affecting the broader healthcare system: stiff competition from hospitals, outpatient centers, and specialty practices that can offer higher pay and different schedules.
Rural providers often feel the pinch most. Even with lower reimbursement rates due to wage index adjustments, they must still offer competitive, sometimes urban-level wages to attract and retain staff. Urban agencies, meanwhile, are competing head-to-head with large health systems for a shrinking pool of qualified professionals.
Small wins in cutting the red tape
The Final Rule does bring some relief in administrative requirements:
These changes can help free up time for direct patient care. It’s an important step, even if it doesn’t close the funding gap.
HOPE on the horizon
CMS’s plan to launch the Hospice Outcomes and Patient Evaluation (HOPE) tool on October 1, 2025, alongside the transition to the iQIES system, is designed to improve quality reporting. However, agencies and vendors are concerned about the compressed timeline for preparation, staff training, and system integration.
Without adequate transition time, the rollout could disrupt workflows, add to clinician workload, and further stress an already taxed workforce.
Why workforce stability matters most
Hospice care is built on the dedication of highly skilled, compassionate teams who guide patients and families through life’s final chapter. Workforce management here isn’t just about staffing levels. It’s about protecting relationships, expertise, and continuity that make hospice care so valuable.
When reimbursement doesn’t match real costs, those essentials are at risk. Sustainable payment policies are critical to ensuring agencies can invest in their people and maintain high-quality care.
Viventium’s commitment
At Viventium, we help hospice providers adapt to regulatory and reimbursement challenges without losing focus on their most important asset – their people. Our payroll and HR technology supports agencies in:
As you prepare for the changes in the FY 2026 Hospice Final Rule, Viventium is here to help your team stay resilient, compliant, and competitive for talent so you can keep delivering exceptional care.
Want to learn how Viventium can help your hospice agency thrive in a challenging environment? Contact us today.