Hospice care not only provides physical and psychological comfort for terminally ill patients and emotional support for their families but also enhances the quality of life in patients at the end of life. However, the unique nature of its medical services poses numerous challenges to basic medical insurance payment. This paper analyzes the current status of hospice care in China from the perspective of basic medical insurance payment, highlighting issues such as insufficient fairness in payment targets, inadequate coverage of payment items, significant variations in service models, imperfect payment methods, low payment standards, regulatory difficulties, and ambiguous cost⁃effectiveness. It proposes innovative pathways to promote equitable coverage and safeguard dignity of life, establish a multi⁃dimensional cost compensation mechanism, build a classified and tiered payment system, and strengthen supervision, management, and health economic evaluations, with the aim of fostering the sustainable development of hospice care in China.

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