United States Hospice Care - Market Share Analysis, Industry Trends & Statistics, Growth Forecasts (2026-2031)

The united states hospice care market size is projected to be USD 29.43 billion in 2025, USD 31.30 billion in 2026, and reach USD 42.58 billion by 2031, growing at a CAGR of 6.35% from 2026 to 2031. This report is Segmented by Level of Care (Routine, Continuous, General Inpatient, Inpatient Respite), Care Setting (Hospice Centers, Home Hospice, Hospitals, Snfs), Patient Diagnosis (Dementia/Alzheimer's, Circulatory/Heart Failure, Cancer, Respiratory, Stroke/Neurovascular, CKD, Other), and Payer (Medicare, Medicaid, Private Insurance, OOP). The Market Forecasts are Provided in Terms of Value (USD).

United States Hospice Care Market Trends and Insights

Aging Population and Multi-Morbidity

The US hospice care market continues to draw long-range support from the expanding older population, with the number of Americans aged 65 and over projected to reach 65 million by 2026. Hospice use among Medicare decedents reached 52.9% in 2024, up by 1.2 percentage points from the prior year, which shows that penetration is still rising even after hospice became a mainstream care pathway. Multi-morbidity is also changing episode economics, because patients with neurological conditions averaged 169 hospice days in 2024, while cancer patients averaged 51 days, creating a materially different revenue profile for providers that can manage more complex symptom patterns. The gap remains meaningful in dementia, where 43% of Medicare beneficiaries diagnosed with dementia used hospice care, versus 45.4% for beneficiaries without dementia, leaving room for targeted outreach and earlier referral pathways. Hospice utilization among beneficiaries with end-stage renal disease reached 31.4% in 2024, and annual US deaths are projected to exceed 3.6 million by 2037, which keeps the demand base for the US hospice care market structurally durable over the forecast period.

Home-Based Hospice Preference

The US hospice care market is being pulled further toward home delivery, with 56% of all hospice claims provided at the patient's residence in 2024, while hospital-based hospice stays fell to 3% of all claims. This shift matters operationally because home hospice growth depends less on adding beds and more on improving admissions velocity, workforce coordination, and referral density around the patient's place of residence. Home Hospice Care is projected to expand at a 9.52% CAGR through 2031, which makes it the fastest-growing care setting in the US hospice care market. Providers that layer remote monitoring, telehealth triage, and stronger caregiver communication into the home model can absorb more admissions without a matching increase in fixed infrastructure or facility overhead. The result is a setting mix that increasingly favors platforms able to combine broad referral reach with flexible field operations, especially in suburban and rural territories where facility alternatives remain limited.

Out-of-Pocket Burden and Payment Caps

The US hospice care market still faces friction from direct patient costs outside the standard Medicare hospice benefit, where uninsured or uncovered services can cost USD 150 to USD 500 per day depending on care intensity. The more persistent pressure point sits with the Medicare aggregate cap, because 28% of hospices exceeded the cap in FY 2023 and average excess payments among above-cap providers reached USD 410,000. Exposure is concentrated among freestanding and for-profit agencies, which represent 82% of all hospice providers but served 60% of Medicare hospice patients, showing a mismatch between provider composition and patient mix. This creates pressure for providers that depend heavily on long-stay and lower-acuity patients, because the same case mix that supports revenue growth can also trigger repayment risk and tighter audit attention. MedPAC's recommendation to eliminate the FY 2027 payment rate update adds another layer of uncertainty to forward planning in the US hospice care market, even though current margins still appear favorable on paper.

Other drivers and restraints analyzed in the detailed report include:

• Medicare and Payer Reimbursement Support
• AI-Enabled Referral Analytics
• Workforce Shortages and RN Turnover

For complete list of drivers and restraints, kindly check the Table Of Contents.

Segment Analysis

Routine Home Care held 89.31% of the US hospice care market in 2025, which confirms that the benefit is still overwhelmingly built around a home-based daily service model rather than short institutional episodes. Its dominance is reinforced by Medicare design, because Routine Home Care accounted for 98.8% of all Medicare-covered hospice days, making it the financial and operational center of the US hospice care industry. CMS set the FY 2026 Routine Home Care rate at USD 230.83 per day for days 1 to 60 and USD 181.94 per day for day 61 onward, preserving the stepped payment structure that shapes provider behavior around longer stays. The scale of this level of care means even small shifts in diagnosis mix can reshape staffing burden, because circulatory, respiratory, and neurological patients often require more frequent symptom response than the historical cancer cohort. As a result, providers are being pushed to adjust care coordination, nurse scheduling, and aide coverage within the dominant service tier rather than relying on inpatient escalation as the default response.

Continuous Home Care is projected to grow at a 9.38% CAGR through 2031, making it the fastest-growing level of care in the US hospice care market as more patients remain at home during acute symptom crises. CMS set the FY 2026 Continuous Home Care rate at USD 1,674.29 for 24 hours of care, which reflects the premium intensity attached to this higher-acuity intervention. Growth in this level is tied closely to advanced heart failure, late-stage dementia, and other conditions where symptom spikes can be managed at home if skilled coverage is available quickly enough. General Inpatient Care and Inpatient Respite Care still remain necessary backstop services, especially when caregiver burden rises or home management fails, but they continue to represent a much smaller share of total days and revenue. The HOPE assessment tool, implemented in October 2025 under the Hospice Quality Reporting Program, adds another layer of operational discipline because missed requirements can trigger a 4% annual payment reduction, which weighs more heavily on smaller providers with thinner compliance capacity.

Hospice Centers held 61.24% of the US hospice care market in 2025, showing that freestanding and concentrated care settings still command the largest share of service delivery even as the home model expands. Facility concentration has historically offered stronger supervision, more predictable staffing, and easier scheduling control, which explains why dedicated centers retained the largest position in the setting mix. The RIHC Hospice Care Chartbook reported that inpatient hospice generated an average stay of 11 days and a median stay of 4 days in 2024, confirming that facility-based care remains concentrated in the final and more intensive phase of care. The provider base also supports this pattern, because for-profit freestanding hospices represented 82% of all providers in 2026 and continue to concentrate activity in settings where staffing, documentation, and margin management can be monitored more tightly. Even so, the setting mix is no longer static, because patient and family preferences are shifting faster than the installed base of dedicated hospice centers.

Home Hospice Care is forecast to grow at a 9.52% CAGR through 2031, making it the fastest-rising setting in the US hospice care market as care increasingly follows the patient rather than the facility. By 2024, 56% of all hospice claims were delivered at the patient's residence, and assisted living facilities accounted for another 21%, which shows that most hospice episodes are already anchored outside hospitals. Hospitals are steadily losing relevance in this setting mix, with hospital-based hospice stays accounting for only 3% of claims in 2024 and hospital-based provider count falling 4.1% between 2023 and 2024. This transition strengthens operators that can run distributed field teams, maintain reliable after-hours response, and use remote triage to support symptoms before they become inpatient events. Over time, that makes home capability less of an add-on service and more of a core competitive requirement inside the US hospice care market.

Complete Report Scope:

• By Level of Care
  • Routine Home Care
  • Continuous Home Care
  • General Inpatient Care
  • Inpatient Respite Care
• By Care Setting
  • Hospice Centers
  • Home Hospice Care
  • Hospitals
  • Skilled Nursing Facilities
• By Patient Diagnosis
  • Dementia and Alzheimer's Disease
  • Circulatory and Heart Failure
  • Cancer
  • Respiratory Disease
  • Stroke and Neurovascular Disease
  • Chronic Kidney Disease
  • Other Terminal Diagnoses
• By Payer
  • Medicare
  • Medicaid
  • Private Insurance
  • Out-of-Pocket and Other Payers

List of Companies Covered in this Report:

• AccentCare
• Agape Care Group / ACG Hospice
• Amedisys (UnitedHealth Group)
• Bristol Hospice
• Care Dimensions
• Chapters Health System
• Compassus
• Crossroads Hospice & Palliative Care
• Elara Caring
• Empath Hospice
• Enhabit Home Health & Hospice
• Gentiva
• Heart to Heart Hospice
• LHC Group Hospice
• Ohio's Hospice
• Silverado Hospice
• St. Croix Hospice
• Traditions Health
• VITAS Healthcare

Additional Benefits:

• The market estimate (ME) sheet in Excel format
• 3 months of analyst support