The hospice industry is expected to receive about $540 million in increased payments in 2020, according to CMS’ proposed hospice payment rule posted April 19 on the Federal Register.
If the rule is finalized as proposed, hospices would receive 2.7% more in payments.
The 2019 payment increase is based on an estimated 3.2% inpatient hospital market basket update, reduced by a 0.5% multifactor productivity adjustment.
By comparison, in 2019 hospices received a payment increase of $340 million (1.8% more than in 2018).
Rule details payment changes for RHC
For hospices that submit quality data and provide routine home care (RHC), the payment rate for days one through 60 would be $195.65 in 2020, compared to $196.25 in 2019.
For days 61 and beyond, payments would be $154.63 in 2020, compared to $154.21 in 2019.
Continuous home care would pay $1,405.81, inpatient respite care would pay $449.78 and general inpatient care would pay $1,027.43. By comparison, in 2019 continuous home care pays $998.38, inpatient respite care pays $176.01 and general inpatient care pays $758.07.
More from the proposed hospice rule
- Election statement requirements proposed. Hospices would be required to provide upon request an election statement addendum to the beneficiary or representative, other providers treating the conditions and to Medicare contractors. The addendum would include a list and rationale for items, drugs and services the hospices determined to be unrelated to the terminal illness and related conditions.
- Wage index updates possible. CMS has proposed using the current IPPS wage index for hospice wage index “to align the data across all of the settings.” Hospice wage index is currently calculated using the previous year’s pre-floor, pre-reclassified hospital wage index data. If finalized, CMS would use the FY 2020 pre-floor, pre-reclassified hospital wage index data for the FY 2020 hospice wage index rather than using the FY 2019 pre-floor, pre-reclassified hospital wage index data.
- CMS is seeking input on the interaction of the hospice benefit with other care delivery models, including Medicare Advantage.