Eli's Hospice Insider

Published on Mon Sep 18, 2017 PDF

Medicare’s quality measure comparison website is now up and running.

If you’ve been having trouble meeting the deadline for pain assessment with the Hospice Item Set, the results are now public.

Medicare’s Hospice Compare website went live Aug. 16, so now potential patients, referral sources, and competitors, among others, can now peruse your quality data.

The site contains data from nearly 3,900 hospices on seven National Quality Forum-endorsed Hospice Item Set quality measures, the Centers for Medicare & Medicaid Services says in a fact sheet about the site (see measures, this page).

Stats: The measure with the lowest national average rate is Pain Assessment. The measure, which gauges “percentage of patient stays during which the patient screened positive for pain and received a comprehensive assessment of pain within 1 day of the screening,” came in at 76.3 percent.

The remaining six measures scored in the mid- to high-90s, with the highest being Treatment Preferences at 98.4 percent.

Why the big difference for the pain measure? “One of the key issues would be not having the assessment completed in the time frame specified,” suspects Theresa Forster with the National Association for Home Care & Hospice. “Hospices only have one day from having a patient screen positive for pain to complete the assessment and have it count.”

Watch out: Whether the national rates will be as high for the CAHPS-based measures that will debut this winter is open to question.

Even though six of the seven measures have average rates in the 90s, the comparison still has value, CMS maintains in its fact sheet. “Even when measure scores may average over 90 percent, there is often a wide range of provider performance representing room for improvement,” the agency says.

Plus: CMS also plans to implement a five-star rating system, as it does for home health agencies and other provider types, soon, it said in the 2017 payment rule.

“The Hospice Compare site allows patients, family members, caregivers, and healthcare providers to compare hospice providers based on important quality metrics,” CMS says in a release.

“The Hospice Compare website is an important tool for the American people and will help empower them in a time of vulnerability as they look for information necessary to make important decisions about hospice care for loved ones,” CMS Administrator Seema Verma says in the release. “The CMS Hospice Compare website is a reliable resource for family members and care givers who are looking for facilities that will provide quality care.”

NAHC praises the site’s launch. “While the initial launch includes only a limited set of process measures, it represents an important step forward in the evolution of the Hospice Quality Reporting Program (HQRP), and sets the hospice program firmly on the road toward greater transparency — on-par with other Medicare providers,” Forster says. “We anticipate significant changes going forward.”

Data Glitch Leads To Bad Press

Watch out: Some hospices’ initiation into Hospice Compare is far from smooth.

For example: A Fargo, North Dakota-based hospice saw “First report card is ugly for Hospice of the Red River Valley” as the headline describing its Compare scores on the Detroit Lakes news website www.dl-online.com.

The not-for-profit hospice, which also operates in Minnesota, was called on the carpet to explain why it scored a dismal 16.6 percent for patients getting a timely and thorough pain assessment when pain was identified as a problem, as opposed to the national average of 77.7 percent.

HRRV head Tracee Capron told the site that it is the first report card issued for hospices, and her agency did not properly self-report the data. “I am 100 percent certain our staff prioritizes pain management,” she assured. HRRV has corrected the EMR-related data collection error, so that the next Compare refresh will reflect their actual practices — which she went on to explain and defend.

Strategy: If you face similar scrutiny for your scores, you may want to take a page from HRRV’s playbook. Capron pointed out that the hospice’s most recently collected data shows that 92.7 percent of patients got a timely and thorough pain assessment when pain was identified as a problem. She also cited improvement for other measures. But the article favorably compared HRRV’s competitor’s scores to its figures.

“It was devastating for us to see (the Hospice Compare report),” Capron said. “We have an excellent reputation, and we know it doesn’t reflect the care we give.”

Meanwhile, if you failed to catch errors such as a wrong address or phone number in your Hospice Compare preview report, you’re not going to see a quick fix for it. “Updates to Hospice Provider demographic information do not happen in real-time and take approximately 6-months to appear on Hospice Compare,” CMS says on a new post to its website.

Do this: Review both your quarterly Hospice Compare Preview Report in ASPEN and the information displayed on the Hospice Compare website itself for accuracy, CMS urges. If there’s a problem, report the correction to your state’s ASPEN coordinator — not CMS directly.

“Hospice information must be updated and uploaded to the national database by the state’s ASPEN Coordinator, as CMS does not have the access or the authority to change the data in the ASPEN system,” according to the website. You’ve already missed the deadline to update your demographic data for the February refresh. It was Sept. 1.

To secure an update for the May refresh, you must submit your correction to your ASPEN state coordinator by Dec. 1, CMS indicates.

Note: More information, including the cut-off date for each quarter and information on locating your ASPEN state coordinator, is at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Hospice-Quality-Reporting/Downloads/Hospice-Compare-Update-8-24-17.pdf. The new site is at www.medicare.gov/hospicecompare. Get tips on reporting your quality data correctly in a Sept. 20 educational call, “Reporting Hospice Quality Data: Tips for Compliance” — register at https://blh.ier.intercall.com.