What to Expect in Hospice Care in 2018

Hospice care providers are in store for some big changes in 2018, including increasing quality reporting requirements and more data revelations on Hospice Compare.

With ongoing shifts across the health care continuum, hospice providers need to be up to date on their data reporting requirements—and understand how their actions today can influence the rule making of tomorrow, according to Theresa Forster, vice president for hospice policy & programs at the National Association for Home Care & Hospice (NAHC), who spoke at the associations’s annual conference in Long Beach, California, last week.

Here’s what hospices can expect in 2018 and beyond:


Payment rate updates

For the fiscal year 2018, hospices were granted a 1% increase in payment rates from the Centers for Medicare & Medicaid Services (CMS). While hospice has seen small increases in payment rates over the last few years, the industry has also been tasked with doing increasingly more reporting.

For example, CMS introduced Hospice Compare in August 2017, giving consumers the chance to see how hospices rank based on the Hospice Quality Reporting Program (HQRP), which reports quality measures related to care.


At the same time, hospice payment have been subjected to rebasing and the “ubiquitous sequester” cuts, which are in effect until 2025, according to Forster.

As hospices are faced with more requirements when it comes to data, providers will have to be particularly stringent in their reporting and data collection, according to Forster. Further down the road, cost reporting data will likely be analyzed for potential revisions of payment rates, as well as future rulemaking, she said.

As such, when it comes to cost reporting, it is “extremely important it is done accurately,” Forster said. “CMS will be looking at [costs] relative to future payment changes.”

The Medicare Payment Advisory Commission (MedPAC), the federal body that advises Congress on health care spending, will also be looking for ways to reduce spending through payment updates in the future and paying attention to new cost reporting data, she said.

The wrong recalibration of payment rates poses a “serious risk” to providers and can result in money lost to hospice care overall in some instances, Forster said.

HCAHPS and Quality Reporting

Hospices will also soon see their scores from the Consumer Assessment of Healthcare Providers & Systems (CAHPS) Hospice survey, which will be displayed with quarterly updates starting in 2018. Home health providers similarly have their CAHPS scores displayed for consumers to see.

Looking ahead, some quality measures for HCAHPS are likely to shift as more providers participate and CMS analyzes feedback. Currently, the CAHPS survey includes several composite and global measures: hospice team communication; getting timely care; treating family members with respect; getting emotional and religious support; getting help for symptoms; getting hospice care training; rating of the hospice; and willingness to recommend.

CMS is also considering adding a measure with the concept of priority areas as part of the Hospice Quality Reporting Program (HQRP), including potential avoidable hospice care transitions and access to levels of hospice care, Forster said.

Furthermore, CMS is working on an assessment tool to transcribe Hospice Item Set (HIS) quality measures from the clinical record into HIS discharge, according to Forster. The tool, Hospice Evaluation & Assessment Reporting Tool (HEART), would be used for admission, discharge and at other intervals, though it is likely still years away from being introduced.

Written by Amy Baxter

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