VectorCare is patient logistics infrastructure for the Medicare hospice benefit. Referrals, level-of-care transfers, and vendor services like DME, pharmacy, transportation, and meals start from the patient chart, go only to verified vendors, and close with confirmed completion matched to the invoice. The hospice keeps its EHR, and the physician makes every clinical call. VectorCare is the verification layer between the chart and the spend.
Illustrative example
Level-of-care change · routine home care to general inpatient
This week
Medicare hospice spending in 2024, for more than 1.8 million beneficiaries.
Source: MedPAC, March 2026 Report to the Congress [S1]
Medicare paid to other providers for hospice patients during hospice care, 2010 to 2019.
Source: HHS-OIG, A-09-20-03015 [S2]
share of Medicare hospice days in 2024 that were routine home care, so most hospice logistics happen in the home.
Source: MedPAC, March 2026 [S1]
The hospice EHR holds the clinical story: diagnoses, encounters, the plan of care, and certifications. The services around the patient live somewhere else. DME, pharmacy, transportation, and meals are ordered by phone, fax, and email, and billed later. When a reviewer asks what was delivered, to whom, by which vendor, and whether it was related to the terminal illness, the answer is spread across inboxes and invoices.
VectorCare wraps that spend around the chart. Every request starts from the patient record, is checked against it, goes only to vendors in good standing, and closes with confirmed completion and an invoice that matches. One audit trail covers every request, vendor, completion, and invoice, tied to the patient.
Every request, vendor, completion, and invoice is tied to the patient and the chart, ready when a Medicare contractor asks.
VectorCare assembles the evidence and suggests. The certifying physician decides.
VectorCare runs inside the hospice's EHR as a SMART on FHIR app, or connects by FHIR or API. Clinicians don't switch systems.
Once a patient elects hospice, the hospice must give or arrange all care for the terminal illness and related conditions, paid through its daily rate [S6] [S3]. Other providers can still bill Medicare for the same patient, and HHS-OIG found that the claim edits meant to stop improper payments were not effective or did not exist [S3].
Federal auditors keep finding the same gap. Vendors often don't know the patient is in hospice [S3], and nothing at the point of care ties a service to the hospice's plan of care. Hospice fraud is a data integrity failure: patients, services, vendors, and invoices that were never checked against the source record.
CMS put a six-month nationwide moratorium on new hospice enrollment in place on May 13, 2026. [S7]
HHS-OIG counted $6.6 billion in these nonhospice payments from 2010 through 2019, averaging 44% of hospice beneficiaries each year, and warned Medicare could pay for the same items or services twice. [S2]
In 121 of 200 sampled DMEPOS items, Medicare improperly paid suppliers for items that palliated or managed a hospice patient's terminal illness. Most suppliers didn't know the patient was in hospice. [S3]
The medical reviewer found they palliated or managed the terminal illness and related conditions, and OIG estimated $190 million in improper payments over five years. [S4]
New hospices in Arizona, California, Georgia, Nevada, Ohio, and Texas can have their claims medically reviewed before payment for 30 days to one year. [S8]
Who pays for a ride or a bed depends on the patient's election date, level of care, and diagnosis. VectorCare records the answer on the request, before anyone is dispatched.
Ambulance transport related to the terminal illness that happens after the effective date of election is the hospice's responsibility, arranged by the hospice and covered by its payment. [S5]
Ambulance transport to the patient's home on the effective date of election happens before the plan of care exists, so Medicare pays it under the ambulance benefit instead. [S5]
General inpatient care is for pain control or symptom management that can't be handled elsewhere, and only in a Medicare-participating hospital, SNF, or hospice inpatient facility. In 2024, 16% of hospice patients had at least one GIP day. [S5] [S1]
Inpatient respite relieves the family caregiver. It is paid at the respite rate for no more than 5 consecutive days at a time. In 2024, 4% of hospice patients had at least one respite day. [S5] [S1]
A clinician starts the request in the patient record through SMART on FHIR, whether it's a hospice referral, a level-of-care change, or a DME, pharmacy, transport, or meal service.
The patient, the hospice election, and the clinical evidence are checked against EHR data. For eligibility and level of care, VectorCare shows the evidence and the physician decides.
Only vendors in good standing, with the right capability and capacity in the patient's area, receive the request. Every vendor that's filtered out shows the reason.
Delivery, pickup, and arrival are confirmed by GPS or by API from the vendor's system, with timestamps.
Each request carries a unique ID. An invoice without a matching, completed request isn't payable.
Results return to the EHR by FHIR, and the full request history stays in one audit trail.
The schemes behind recent hospice enforcement map one to one to checks VectorCare runs on each request.
Ghost patients
No real record in the EHR, no request.
Ghost services
A service without GPS or API confirmation isn't payable.
Phantom or duplicate billing
No matching request, no payment.
Kickback recruiting
Requests come from a clinician in the chart, not an outside marketer.
Sham vendors
NPI, Medicare enrollment, and exclusion lists are checked before a request reaches a vendor, and rechecked over time.
Spend outside the benefit
Each service is tagged to the plan of care, so related care is arranged and paid by the hospice.
Schedule, verify, and pay the services around each patient from one place, with the evidence already attached.
When a patient elects hospice at discharge, the referral, the placement, and the ride home run inside the chart.
An inpatient with a terminal diagnosis chooses hospice. Today the case manager calls hospices one by one, faxes records, and books the ride home separately.
With VectorCare, the physician sees the eligibility evidence in the chart, certification and election are signed and written back, and the referral goes only to hospices in good standing with capacity. The ride home is booked and tracked from the same request, and the audit trail shows every step.
A hospice nurse finds that symptoms can no longer be managed at home. The physician confirms general inpatient care, and the request only offers Medicare-participating facilities with an open bed.
Because the transport is related to the terminal illness, it's arranged and paid by the hospice [S5], and the request records that. Arrival is GPS-confirmed, the invoice matches the request ID, and the chart shows the transfer.
VectorCare has completed a SOC 2 Type II audit, is HIPAA compliant, signs BAAs with every covered entity, hosts on AWS in the United States, and is listed on Epic's Connection Hub. Full data export is available on request. See security details.
See a referral, a level-of-care transfer, and a vendor service run end to end inside the EHR.