Medicare’s hospice payments, adjusted for inflation and other factors, will rise an estimated 2.1% in 2017, according to the final hospice payment rule posted July 29. And CMS will begin collecting data on two new quality measures starting in April 2017.
 
The $350 million increase is the result of a 2.7% market basket update reduced by, among other things, a 0.3% productivity adjustment. The payments don’t take the sequester into account.
 
By comparison, the 2016 final rule included a 1.1% increase — $160 million — in payments.
 
The final rule will officially be published in the Federal Register Aug. 5 and become effective Oct. 1, a CMS fact sheet about the rule states.
For routine home care, the payment rate for days 1-60 will be $190.55 in 2017, compared to $186.84 in 2016. For days 61 and beyond, payments will be $149.82 in 2017, compared to $146.83 in 2016.
 
The service intensity add-on (SIA) payment rate will be $40.19 per hour.
 
How the rule will affect areas’ payments
 
Urban areas will experience an average 2.1% payment increase as a result of the rule, while rural areas will experience a 2.0% increase, the rule states.
 
Hospices in the urban Pacific and rural Pacific regions will have the largest increases — 2.7% and 2.8%, respectively.
 
Meanwhile, hospices in the West North Central region would experience the lowest payment increase, 1.1%.
 
Rule creates two quality measures
 
The final rule also creates two new quality measures. The first is a hospice and palliative care composite process measure and the second is hospice visits when death is imminent. Data collection for the measures will begin April 1, 2017.
 
The hospice and palliative care composite process measure will measure the percentage of patients who receive the following processes: patients treated with an opioid who are given a bowel regimen, pain screening, pain assessment, dyspnea treatment, dyspnea screening, treatment preferences, and beliefs/values addressed (if desired by the patient).
 
The second measure that CMS will introduce assesses the percentage of patients receiving at least one visit from RNs, physicians, nurse practitioners or physician assistants in the last three days of life. And the measure assesses the percentage of patients receiving at least two visits from medical social workers, chaplains or spiritual counselors, licensed practical nurses or hospice aides during the last seven days of life.
 
More changes in the hospice rule
  • HIS changes. CMS is enhancing the HIS data collection instrument so it’s in line with other post-acute care settings. “This revised data collection instrument would be a comprehensive patient assessment instrument rather than the current chart abstraction tool,” according to the federal Medicare agency.
  • Hospice CAHPS survey updates. The final rule outlines participation requirements for the 2019 and 2020 annual payment updates and includes survey data submission deadlines for the 2018, 2019 and 2020 annual payment update periods. CMS anticipates public display of data will occur in 2017. 
Related link: View the hospice rule at http://bit.ly/2aQouXA.
 
Editor’s Note: For more in-depth analysis of this rule, go to: www.homehealthline.com.