Compiled by the Lily Hospice team from federal and state sources. Updated September 30, 2026. Every number links to its source; free to cite with attribution to Lily Hospice (lilyhospice.com). Questions: (248) 955-5100, answered 24 hours a day.
The short version: about half of Americans on Medicare now use hospice before they die (52.9% in 2024), and Michigan uses it a little more than the nation (49.7% versus 46.9% in the latest state comparison). Michigan has 173 Medicare-certified hospices, and 104 of them list Oakland, Macomb or Wayne County in their service area. The typical stay is short (a median of 19 days nationally), and more than a quarter of people enroll only in their last week, often too late to get the full benefit. Starting October 1, 2026, Medicare pays a hospice $236.35 a day for most home-care days, and families usually pay nothing or close to nothing.
Hospice in the United States (Medicare, 2024)
| Measure | Number | Source |
|---|---|---|
| Medicare beneficiaries who received hospice | More than 1.8 million | MedPAC, March 2026, ch. 10 |
| Share of Medicare decedents who used hospice | 52.9% (51.7% in 2023) | MedPAC, March 2026 |
| Average length of stay (decedents) | 99.6 days | MedPAC, March 2026 |
| Median length of stay (decedents) | 19 days | MedPAC, March 2026 |
| People who enroll only in their last week | More than one in four hospice decedents | MedPAC, March 2026 |
| Average stay by setting | 174 days in assisted living, 120 in nursing facilities, 100 at home | MedPAC, March 2026 |
| Hospices providing care | 6,706, about 82% for-profit | MedPAC, March 2026 |
| Medicare hospice spending | $28.3 billion | MedPAC, March 2026 |
| Days billed as routine home care | 98.8% of all hospice days | MedPAC, March 2026 |
| Leading diagnosis groups at admission | Circulatory 29.8%, neurovascular 25.4%, cancer 22.3%, respiratory 10.1%, kidney 3.0% | National Alliance for Care at Home, Facts and Figures 2025 |
Why the short median matters: hospice helps most when it has time to control symptoms, train the family and build trust. A median stay of 19 days means half of all patients get less than three weeks. If you are wondering whether it is time, our Is It Time? guide and self-check can help.
Hospice in Michigan
| Measure | Number | Source |
|---|---|---|
| Medicare-certified hospices in Michigan | 173 (93 for-profit, 38 non-profit, 8 other or government, 34 with no ownership type reported) | CMS Hospice General Information, updated August 19, 2026 |
| Medicare decedents in hospice at death | 49.7% in Michigan versus 46.9% nationally (2022); Michigan ranked 15th | America's Health Rankings, from NHPCO data |
| Hospice Care Index (0 to 10) | Michigan average 9.0; national 8.8 (2023 to 2024) | CMS Care Compare state and national data |
| Patients visited by a nurse or social worker in the last days of life | Michigan 63.3%; national 48.3% (2023 to 2024) | CMS Care Compare |
| Family caregivers who rated their hospice 9 or 10 | Michigan 83%; national 83% (Oct 2023 to Sep 2025) | CMS Hospice CAHPS |
| Caregivers who would definitely recommend their hospice | Michigan 84%; national 85% | CMS Hospice CAHPS |
| Medicare claims contractor for hospice | National Government Services (Home Health and Hospice, Jurisdiction 6) | CMS |
| Hospice licensing | Michigan Department of Licensing and Regulatory Affairs (LARA) | State of Michigan |
Hospice in metro Detroit (Oakland, Macomb and Wayne counties)
From Lily Hospice's analysis of the same CMS files, published as The State of Hospice in Metro Detroit, 2026 with the full Metro Detroit Hospice Directory.
| Measure | Number |
|---|---|
| Medicare-certified hospices listing any of the three counties | 104 (73 list all three; 70 are based in the three counties) |
| Certified in 2020 or later | 37 of 104 |
| Hospices with a published family-caregiver star rating | 53 of 104 |
| Patients visited in the last three days of life | Ranges from 6.5% to 93%; median 60.9% (85 hospices with data) |
| Median nurse minutes per routine home care day | 12.4 |
| Median share of live discharges within 7 days of admission | 7.6% (highest 33.3%) |
| Hospices covering 80% or more of the ZIP codes in all three counties | 5 |
What this means for families: the hospice you choose matters. Ask any hospice for its last-days visit rate, its family rating and who answers the phone at night, and confirm it serves your ZIP code. Our guide to choosing a hospice walks through the questions, and Lily publishes its own numbers, good and bad, on our quality scores page.
What Medicare pays a hospice (national base rates)
| Level of care | Oct 1, 2025 to Sep 30, 2026 | From Oct 1, 2026 |
|---|---|---|
| Routine home care, days 1 to 60 | $230.83 a day | $236.35 a day |
| Routine home care, day 61 and after | $181.94 a day | $186.35 a day |
| Continuous home care (crisis care at home) | $1,674.29 per 24 hours | $1,726.50 per 24 hours ($71.94 an hour) |
| Inpatient respite care | $532.48 a day | $545.98 a day |
| General inpatient care | $1,199.86 a day | $1,231.63 a day |
| Aggregate cap (average per patient, per hospice, per year) | $35,361.44 | $36,174.75 |
Rates are for hospices that report quality data, before adjustment for local wages; the payment update is +2.6% for FY 2026 and +2.3% for FY 2027. Hospices that do not report quality data get four percentage points less. Sources: FY 2026 hospice final rule; CMS FY 2027 hospice final rule fact sheet.
What families pay: under Medicare, up to $5 for each prescription for pain and symptom control and 5% of the Medicare-approved amount for inpatient respite care. Room and board in assisted living or a nursing home is not covered by Medicare. See how much hospice costs in Michigan.
What changed in 2025 and 2026
- October 1, 2025: hospices began using the HOPE patient assessment in place of the older Hospice Item Set (CMS).
- January 1, 2025: the Medicare Advantage hospice test (the VBID hospice component) ended; Original Medicare again pays hospice for all Advantage members (CMS).
- February 2025: CMS paused the hospice Special Focus Program to re-evaluate it.
- October 1, 2026 (FY 2027 rule): hospices must give every patient an addendum listing items and services they consider unrelated to the terminal illness; a new spending-variation index flags unusual billing; more hospice physicians may approve a discharge; and Care Compare will later flag hospices that do not report quality data (CMS).
Common questions about hospice numbers
How many hospices are there in Michigan?
173 Medicare-certified hospices, according to the CMS file updated August 19, 2026. 104 of them list Oakland, Macomb or Wayne County in their service area.
What percentage of people use hospice?
52.9% of Medicare beneficiaries who died in 2024 used hospice. In Michigan, 49.7% of Medicare decedents were in hospice at death in 2022, above the national 46.9% for that year.
How long do people usually stay on hospice?
Nationally the median stay is 19 days and the average is 99.6 days; more than one in four people enroll only in their last week. There is no limit on how long someone can receive hospice as long as they still qualify. See how long you can be on hospice.
How much does Medicare pay for hospice in 2026?
Through September 30, 2026, $230.83 a day for the first 60 days of routine home care and $181.94 a day after that; from October 1, 2026, $236.35 and $186.35. The family usually pays nothing beyond small prescription copays.
How do Michigan hospices compare on quality?
Michigan hospices average 9.0 on Medicare's Hospice Care Index (national 8.8) and visit 63.3% of patients in the last days of life (national 48.3%). Individual hospices vary widely; compare them in our Metro Detroit Hospice Directory or on Medicare Care Compare.
Related: Hospice glossary · Hospice questions answered · Does Medicare cover hospice in Michigan? · Facts about Lily Hospice
Hospice isn't giving up. It's showing up.