Medicare’s hospice payments, adjusted for inflation and other factors, will rise an estimated 1% in 2018, according to the final hospice payment rule posted Aug. 1.
 
 That’s a $180 million increase.
 
 By comparison, the 2017 final rule included a 2.1% increase — $350 million — in payments.
 
The dropoff is largely due to a one-time reduction in the payment update due to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). To help pay for MACRA, hospices will receive 1% less in payments than they would have in 2018.
 
For routine home care, the payment rate for days 1 through 60 will be $192.78 in 2018, compared to $190.55 in 2017. For days 61 and beyond, payments will be $151.41 in 2018, compared to $149.82 in 2017.
 
The changes are effective Oct. 1, 2017.
 
More from the final hospice rule
  • CMS addresses future plans to change hospice eligibility requirements. The proposed rule solicited comments for future rulemaking about amending regulations at §418.25 to specify that a referring facility/physician’s medical record would need to be used for initial eligibility determinations. Many commenters expressed concerns. Hospices contend they already gather and analyze clinical information from sources including referring providers. CMS agreed that regulations “require such information to accompany the certification of terminal illness,” CMS wrote in the final rule. “While we are not proposing a change in the regulations at this time, we plan to work with our Medicare Administrative Contractors (MACs) to confirm whether they are requesting such information when claims are selected for medical review and, if not, whether such information should be included in any additional documentation requests.”
  • Hospice Compare update. CMS will begin public reporting of quality data via Hospice Compare in August 2017. Initially only Hospice Item Set (HIS) data will appear. Hospice CAHPS data will be added in winter 2018.
  • CMS receives feedback on HIS-based measures for future years. CMS didn’t add measures to the HIS this year, but it received feedback on two measures under future consideration: “Potentially avoidable hospice care transitions” and “Access to levels of hospice care.”
  • Work is ongoing into creating a Hospice Evaluation & Assessment Reporting Tool (HEART). CMS had discussed in the 2017 rule how it was in the early stages of developing a new data collection mechanism for hospices. The work continues, and CMS received public feedback on the HEART. 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 link: Read the final rule at http://bit.ly/2uWbE3T.