Hospice final rule means larger payment increase than expected

Effective Jul 27, 2022

Published Jul 27, 2022

Last Reviewed Jul 27, 2022

The hospice payment increase for fiscal year 2023 climbed to 3.8%, up from 2.7% proposed in March, according to the FY 2023 Hospice Payment Rate Update Final Rule released Wednesday afternoon. The equates to an estimated increase in payments of $825 million from FY2022.

The statutory aggregate cap will be $32,486.92, up from $31,297.61 in the current fiscal year.

The final rule establishes a permanent cap on negative wage index changes at 5%. In comments following the proposed rule, some industry leaders had called for a smaller percentage%.

CMS stated in the final rule that it was sticking with 5% “because it would more effectively mitigate any significant decreases in a hospice’s wage index for future FYs, while still balancing the importance of ensuring that area wage index values accurately reflect relative differences in area wage levels.”

CMS noted several updates in the final rule in advance of future changes to the Hospice Quality Reporting Program, including the anticipated Hospice Outcomes and Patient Evaluation (HOPE) assessment tool and an updated web-based CAHPS Hospice Survey. Considerations for a future HQRP measure on health equity was also noted in the final rule.

While not yet available, the final rule noted the hospice wage index applicable for FY 2023 (October 1, 2022, through September 30, 2023) will be available on the CMS website at: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/Hospice/Hospice-Wage-
Index.html.

See the CMS release on the hospice final rule: https://go.cms.gov/3bhc8LD.
See the final rule text: https://public-inspection.federalregister.gov/2022-16214.pdf.

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