Medicare’s hospice payments, adjusted for inflation and other factors, would rise an estimated 2% in 2017, according to the proposed hospice payment rule posted April 21.
 
The $330 million increase is the result, among other things, of a market basket update reduced by a productivity adjustment and a point adjustment set by the Affordable Care Act.
 
By comparison, the 2016 final rule included a 1.1% increase — $160 million — in Medicare’s hospice payments.
 
Under the 2017 rule, hospices in rural and urban areas would experience an average increase of 2% and 1.9%, respectively. Hospices in the urban Pacific and rural Pacific regions would experience the largest increases — 2.6% and 2.7% — while hospices in the West North Central region only would experience a 1% increase.
 
For routine home care, the payment rate for days one through 60 would be $190.41 in 2017, compared to $186.84 in 2016.
 
For days 61 and beyond, payments would be $149.68 in 2017, compared to $146.83 in 2016.
 
CMS proposes new quality measures
 
CMS also is seeking to add two new quality measures for the 2017 fiscal year. Data collection for the measures would begin April 1, 2017.
 
The first measure, hospice visits when death is imminent, will assess hospice staff visits to patients and caregivers in the last week of life. CMS proposed four new items be added to the Hospice Item Set (HIS) discharge record so necessary data elements could be collected for the measure. The second measure CMS proposed, hospice and palliative care composite process measure, will assess the percentage of hospice patients who received care processes consistent with guidelines.
 
That “will be based on select measures from the seven that are currently being submitted under the Hospice QRP (pain screening, pain assessment, dyspnea treatment, patients treated with an opioid who are given a bowel regimen, and treatment preferences and beliefs/values addressed if desired by patient),” CMS says.
 
More changes in proposed rule
  • HIS changes. CMS may enhance the HIS data collection instrument so it’s in line with other post-acute care settings, according to the proposal. “This revised data collection instrument would be a comprehensive patient assessment instrument, rather than the current chart abstraction tool,” according to CMS. Hospices can use such a data set as a way to have valid and reliable information for care planning, patient assessment and service delivery, the proposal contends. “This will enable greater accuracy in quality reporting; decrease provider burden; help surveyors ensure hospices are meeting Conditions of Participation (CoP) and providing high quality patient care; and, in the future, enable payment determinations,” CMS says.
  • Hospice CAHPS updates. The proposal 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.
  • Hospice Compare coming soon. CMS expects to public reporting via a Hospice Compare website to occur in 2017. CMS also expects to post hospice demographic data on a public use file at https://data.medicare.gov, beginning later this spring or in early summer.
Related link: View the proposed rule at http://1.usa.gov/1pmh6Ze. Comments will be accepted until 5 p.m. EST June 20.