Hospice Updates
Hospice Rule Finalized
The Centers for Medicare and Medicaid Services (CMS) released the FY 2020 hospice final rule earlier this month. It is available for public inspection on the Federal Register here, and a CMS fact sheet is here.
The rule provides for:
- a 2.6 percent payment update;
- rebasing of three of the four types of hospice care – general inpatient care (GIP), continuous home care (CHC), and inpatient respite care (IRC) – to more accurately align rates with costs. This comes with an unfortunate 2.72 percent reduction to routine home care (RHC) to maintain budget neutrality; and
- modifications to the hospice election statement and a new addendum with a list and rationale for items, drugs, and services that the hospice has determined to be unrelated to the terminal illness and related conditions.
Some of LeadingAge's comments related to the burden associated with the new addendum are reflected in CMS's comments, and CMS took some of our suggestions to increase the time frames that will be required to complete and share the addendum, more accurately reflect the administrative burden, and delay implementation until FY 2021 to allow for the operationalization of this new condition of payment. We strongly opposed the routine home care payment reduction, as this is the bulk of hospice care for providers. LeadingAge National offers a summary here. Also, this year, LeadingAge National is going to be able to offer a hospice rate calculator for members.
"Getting Started with Hospice CASPER Review and Correct Reports" is Now Available
“Getting Started with Hospice CASPER Review and Correct Reports” is now available for download. This CMS document is intended to help providers understand what the Review and Correct Reports are and how to use them.
To download the document, please refer to the “Downloads” section of the Hospice Quality Reporting Program (HQRP) Requirements and Best Practices page on the CMS site.
Hospice Compare Quarterly Refresh Available
The August 2019 quarterly Hospice Compare refresh of quality data is now available. It is based on Hospice Item Set (HIS) quality measure results from data collected from Quarter 4, 2017 to Quarter 3, 2018 and Hospice Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey® results reported from Quarter 4, 2016 to Quarter 3, 2018.
Beginning with the August 2019 refresh, Hospice Compare will include hospice provider performance scores on the Hospice Visits when Death is Imminent three-day measure, which assesses the percentage of patients who receive at least one visit from a registered nurse, physician, nurse practitioner, or physician assistant in the last three days of life. CMS has decided not to publish Measure 2, the seven-day measure, at this time to allow further testing to determine if changes to the measure or how it would be displayed on Hospice Compare are needed. Additional testing will help ensure the measure’s accuracy and reliability as an indicator of provider quality. CMS will not post data for this measure, including each hospice’s performance as well as the national rate, while conducting more testing. The decision not to publicly report the seven-day measure at this time has no impact on other HQRP measures.
Visit Hospice Compare to view the data. For additional information on the Hospice Visits when Death is Imminent measure, view the associated Fact Sheet and Q & A documents.
Reminder – Focus Group Opportunity for Hospice Providers
CMS has contracted with Abt Associates, Inc. to recruit experienced hospice providers and clinical staff to participate in virtual focus groups to provide input on the hospice patient assessment instrument. The focus groups will be conducted via webinar using the WebEx platform.
CMS's new hospice instrument will apply a patient-centered approach that supports patient choice and incorporates the full hospice team. At a minimum, the data from the assessment instrument will be used for care planning and outcome quality measures. Therefore, participation in the focus groups is an integral part of the new assessment instrument development. The feedback from these groups will inform CMS's recommendations as part of the steps to prepare for alpha testing of the hospice patient assessment instrument in Calendar Year (CY) 2020.
All interested participants with experience with the HQRP or collecting patient-level data will be considered based on their hospice role, knowledge, and experience with the HQRP or completing patient assessments. Selection will take into account hospice type and location to ensure a nationally balanced representation of diverse hospices.
We urge LeadingAge NY members to participate. Please see the Recruitment Announcement, which includes the link for completing the Focus Group Application. This is also posted in the "Downloads" section of the HQRP Provider Engagement Opportunities webpage here. Please complete the Focus Group Application by Aug. 26, 2019.
If you have general questions about the focus groups and would like to contact CMS, please email Cindy Massuda, CMS’s HQRP Coordinator, at Cindy.Massuda@cms.hhs.gov.
Contact: Meg Everett, meverett@leadingageny.org, 518-867-8871