Hospice: Quality Rules, Pay for 2017 Released

Final changes to the hospice quality reporting program, along with new wage index, payment rates, and cap amounts for 2017 have been announced by the Centers for Medicare & Medicaid Services (CMS). The rule looks to the future, as well, describing a new data collection instrument.
This is important with two new quality measures — Hospice Visits when Death is Imminent and Hospice and Palliative Care Composite Process Measure — being added to the rest that are required of providers of end-of-life care. CMS plans to publicly display quality measures and other hospice data beginning calendar year 2017.

Quality is the End Goal

This final rule provides a description of the Hospice CAHPS® Survey, a component of the Hospice Quality Reporting Program (QRP),  including the model of survey implementation, the survey respondents, eligibility criteria for the
sample, and the languages in which the survey is offered, among other details. The final rule also outlines participation requirements for the fiscal year 2019 and fiscal year 2020 annual payment updates (APU).

• For fiscal year 2019 APU, hospices must collect survey data on an ongoing basis from January through December of calendar year 2017.
• For the fiscal year  2020 APU, hospices must collect survey data on an ongoing basis from January through December of calendar year 2018. The final rule also includes survey data submission deadlines for the FY 2018, FY 2019, and FY 2020 APU periods.

Public display of the survey results will not occur until CMS has collected at least four quarters of data. CMS anticipates public display of the data will occur during calendar year 2017. CMS began collecting data in June.

Payment Based on Quality

Hospices would see a 2.1 percent ($350 million) increase in their payments for fiscal year 2017, according to the new rule. This reflects an estimated 2.7 percent inpatient hospital market basket update, reduced by a 0.3 percentage point productivity adjustment and a 0.3 percentage point adjustment required by law.
As discussed in the  2016 Hospice Wage Index and Payment Rate Update final rule (80 FR 47183), CMS  implemented changes required by the Improving Medicare Post-Acute Care Transformation Act of 2014 (Pub. L. 113-185) (IMPACT Act). For accounting years that end after Sept. 30, 2016 and before Oct. 1, 2025, the hospice cap is updated by the hospice payment update percentage rather than using the consumer price index for urban consumers (CPI–U). As required by section 1814(i)(2)(B)(ii) of the Act, the hospice cap amount for the 2017 cap year will be $28,404.99, which is equal to the 2016 cap amount ($27,820.75) updated by the 2017 hospice payment update percentage of 2.1 percent.
The 2017 cap year will start on October 1, 2016 and end on September 30, 2017.As a reminder, in the FY 2016 Hospice Wage Index and Payment Rate Update final rule (80 FR 47142).  Table 26 in the FY 2016 Hospice Wage Index and Payment Rate Update final rule (80 FR 47185) outlines the time frames for counting beneficiaries and payments during the 2017 transition year.

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Brad Ericson

Director of Publishing at AAPC

Brad Ericson, MPC, CPC, COSC, is a seasoned healthcare writer and editor.He directed publishing at AAPC for nearly 12 years and worked at Ingenix for 13 years and Aetna Health Plans prior to that. He has been writing and publishing about healthcare since 1979. He received his Bachelor's in Journalism from Idaho State University and his Master's of Professional Communication degree from Westminster College of Salt Lake City.

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