The fiscal year 2025 hospice payment increase will be 2.9%, according to the final rule released Tuesday, July 30. That’s an estimated increase of $790 million in payments from fiscal year 2024. The proposed payment update released in March was 2.6%. 
 
CMS also finalized new quality measures around pain response, the new Hospice Outcomes and Patient Evaluation (HOPE) instrument and Hospice CAHPS survey updates (including a new timeline for the rollout of the CAHPS changes). 
 
The finalized hospice cap amount for fiscal year 2025 is $34,465.34, up from the current amount of $33,494.01. 
 
HQRP and HOPE 
 
This rule finalizes two new process measures that will be added to the Hospice Quality Reporting Program (HQRP): Timely Follow-up for Pain Impact and Timely Follow-up for Non-Pain Symptom Impact.  
 
These process measures address hospice care delivery as they document whether a follow-up visit occurred within 48 hours of an initial assessment with a report of moderate or severe symptoms with and without pain, CMS notes.  
 
Inclusion in the HQRP will begin in fiscal year 2028, but hospices will begin collecting the data with the HOPE instrument in October 2025. 
 
The HOPE instrument will replace the Hospice Item Set (HIS) in the HQRP. HOPE will collect data at multiple time points across the hospice stay, including admission, the HOPE Update Visit (HUV) and discharge, CMS notes. 
 
CAHPS 
 
The rule is delaying final implementation of changes to the CAHPS Hospice Survey until decedents in April 2025. They had previously planned finalization for decedents beginning in January 2025.  
 
Changes include:
  • The addition of a web-mail mode (email invitation to a web survey, with mail follow-up to non-responders)
  • A shortened and simplified survey  
  • Modifications to survey administration protocols to include a pre-notification letter and extension of the field period from 42 to 49 days  
  • The addition of a new, two-item Care Preferences measure  
  • Revisions to the existing Hospice Team Communication measure and the existing Getting Hospice Care Training measure 
  • The removal of three nursing home items and additional survey items impacted by other proposed changes in this rule 
The final rule also summarizes public comments received related to:  
  • The request for information regarding implementing a separate payment mechanism to account for high-intensity palliative care services 
  • The request for information regarding potential Social Determinants of Health (SDoH) elements 
The rule also provides updates on health equity, future quality measures (QMs) and public reporting requirements. 
 
Read the Fiscal Year 2025 Hospice Wage Index and Payment Rate Update final rule at https://public-inspection.federalregister.gov/2024-16910.pdf
 
Look for more coverage in an upcoming issue of Home Health Line.