WASHINGTON — A bipartisan coalition of U.S. senators and national healthcare advocacy organizations is advancing a proposed community-based palliative care model that would bring symptom management and care coordination services to Medicare beneficiaries earlier in their illness — and more consistently at home.
The effort centers on Senate Bill 1935, the Expanding Access to Palliative Care Act, reintroduced on June 5, 2025, by Senators Jacky Rosen (D-NV), John Barrasso (R-WY), Deb Fischer (R-NE), and Tammy Baldwin (D-WI). The legislation would direct the Center for Medicare and Medicaid Innovation (CMMI) to test a model providing longitudinal, community-based palliative care for high-risk Medicare beneficiaries beginning at the time of a serious illness or injury diagnosis.
Under the proposed model, palliative care services would be delivered across multiple settings — including a patient’s home, community clinics, long-term care facilities, and via telehealth — rather than being confined to hospital-based or end-of-life care. Proponents say the approach would reduce unnecessary hospitalizations, lower overall healthcare costs, and improve quality of life for patients and their families.
Bridging a Persistent Access Gap
The legislation addresses a structural gap that palliative care advocates have long identified: most seriously ill patients do not receive palliative care support until late in their illness, often only after hospital admission. According to the Center to Advance Palliative Care (CAPC), an earlier, home-based approach would align with patient preference — most seriously ill individuals express a desire to remain at home — while also better supporting the family caregivers who bear much of the daily care burden.
The National Partnership for Healthcare and Hospice Innovation (NPHI) and the Coalition to Transform Advance Care (C-TAC) are among the advocacy organizations backing the legislation. Both groups have argued that existing Medicare reimbursement structures do not adequately compensate providers for the true cost of delivering community-based palliative care, creating a financial barrier to service expansion — particularly in rural and underserved communities.
S.1935 would require CMMI to update Medicare reimbursement fee schedules to more accurately reflect the cost of providing palliative services to patients with serious illnesses.
Parallel Workforce Legislation
Running alongside the demonstration model bill, Senate Bill 2287 — the Palliative Care and Hospice Education and Training Act — would authorize $15 million per year from fiscal years 2026 through 2030 to expand palliative care training across medical specialties. A House companion measure, H.R. 4425, mirrors the Senate version’s funding structure and goals.
The training legislation specifically targets workforce shortages in rural and medically underserved areas, frontier health professional shortage areas, and communities served by Indian Tribes and Tribal organizations — regions where palliative care access has historically been most limited.
Rural Access Remains the Central Challenge
Community-based palliative care programs have faced particular difficulty sustaining operations outside major metropolitan areas. According to McKnight’s Home Care, rural providers often lack the medical organizations or health systems capable of subsidizing home-based services when Medicare reimbursement falls short of delivery costs. Telehealth and virtual palliative consultations are being explored as bridging solutions, but advocates say durable payment reform is essential to making those models financially viable.
The Center for Medicare and Medicaid Innovation is also scheduled to launch the Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model on July 1, 2026 — a 10-year initiative to expand technology-enabled care options for patients with chronic conditions. Palliative care providers have noted this initiative could complement community-based palliative care expansion efforts already underway.
Background
Palliative care is specialized medical care focused on relieving pain, symptoms, and the stress of serious illness. Unlike hospice care, which is reserved for patients with a terminal prognosis, palliative care can be provided alongside curative or active treatment at any stage of illness. Despite evidence that early palliative care improves outcomes and reduces hospitalizations, access remains uneven across geographic regions, care settings, and payer types.
The Expanding Access to Palliative Care Act has been introduced in prior congressional sessions, reflecting years of sustained advocacy to establish a formal community-based payment model within Medicare.
Why This Matters for Home Care
For the millions of Americans managing serious illness at home, the absence of structured palliative care support often means families absorb much of the care coordination and symptom management burden with limited clinical backup — a challenge that falls disproportionately on communities distant from major medical centers.
For families providing palliative or comfort care at home, proper equipment plays a central role in managing day-to-day comfort between clinical visits. The SonderCare Aura line’s full positioning suite — including Zero Gravity, Comfort Chair, and Trendelenburg positioning — allows caregivers to adjust a loved one’s position for pain and symptom relief without a hospital transfer.
If your family is navigating palliative or hospice care at home, SonderCare’s home hospital beds are designed to support the comfort and dignity of that journey. Explore SonderCare’s home hospital beds or call our care specialists to discuss which configuration best fits your situation.
Sources: Hospice News (May 22, 2026); Center to Advance Palliative Care; McKnight’s Home Care; Congress.gov (S.1935, S.2287, H.R. 4425)
