Medicare’s hospice payments, adjusted for inflation and other factors, would rise an estimated 1% in 2018, according to the proposed hospice payment rule posted April 27.
 
That’s a $180 million increase.
 
By comparison, the 2017 final rule included a 2.1% increase — $350 million — in payments.
 
For routine home care, the payment rate for days 1 through 60 would be $192.80 in 2018, compared to $190.55 in 2017. For days 61 and beyond, payments would be $151.41 in 2018, compared to $149.82 in 2017.
 
Hospices in urban Pacific and rural Middle Atlantic regions would experience the largest payment increases (1.7% and 1.6%, respectively) while hospices in urban New England only would experience a 0.3% increase.
 
More from the proposed hospice rule
  • CMS will release Hospice Compare this summer. But the site won’t include Hospice CAHPS measures until winter 2018.  Hospice Compare ultimately will include “a quality rating system that gives each hospice a rating of between 1 and 5 stars,” the rule states. Through future rulemaking, CMS will announce the timeline for developing and implementing star ratings.
  • CMS discusses HIS-based measures for future years. One priority area: “Potentially avoidable hospice care transitions.” Such transitions, CMS says, are associated with adverse outcomes and higher health care costs, among other things. Encouraging hospices to assess and manage patients’ risk of care transitions potentially could improve the quality of care at the end of life. A second priority area: Access to levels of hospice care. Hospices have four levels of care — routine home care, continuous home care, general impatient care and inpatient respite care. A measure involving access of levels of hospice care would “assess the rates at which hospices provide different levels of hospice care,” the rule states. Such a measure, CMS says, “has the potential to improve access to various levels of care for patients and caregivers.” Measuring the use of levels of care would incentivize hospices to continuously assess the needs of patients and caregivers, providing correct level of care to meet these needs, according to the rule.
  • Work is ongoing into creating a Hospice Evaluation & Assessment Reporting Tool (HEART). CMS had discussed in last year’s rule how it was in the early stages of developing a new data collection mechanism for hospices. The work continues. HEART would be a hospice patient assessment tool that CMS says accomplishes two main things: Providing quality data necessary for quality reporting requirements and the current function of the HIS, and providing more clinical data to “inform future payment refinements.” 
Related links: Read the proposed rule at http://bit.ly/2p8IE89. View CMS' fact sheet about the proposed rule at http://bit.ly/2qcRqmK. Comment on the rule by no later than 5 p.m. EST June 26. Submit comments electronically at www.regulations.gov.