Eli's Hospice Insider

Published on Thu May 14, 2015 PDF

Your claims and cost report data could determine the next phase of reform.

If you were expecting a complete overhaul of the hospice payment system under the payment reform mandate from the Affordable Care Act, just wait — it still may come.

The Centers for Medicare & Medicaid Services takes pains to point out that payment reform would be far from over under this proposal. “The proposed [routine home care] rates … and [service intensity add-on] payment would advance hospice payment reform incrementally … while simultaneously maintaining flexibility for future refinements,” the agency says in the 2016 proposed rule published in the May 5 Federal Register. “CMS needs to further assess whether the four levels of care and the current payment amounts, as well as the amounts after implementation of the SIA, will align with the actual cost of providing hospice services.”

It’s on you: That means hospices’ own data will be steering the payment reform course. “The hospice cost report was redesigned, effective for cost reporting periods beginning on October 1, 2014, and additional data are now being collected on the hospice claim form, effective April 1, 2014,” CMS points out. “Once additional data is available, CMS will continue to assess additional refinements that may inform more extensive policy and payment approaches.”