CMS Proposes $340 Million Increase in Hospice Payments for 2019

Hospice providers could be getting a 1.8%, or $340 million, bump in reimbursements in fiscal year 2019, the Centers for Medicare & Medicaid Services (CMS) proposed Friday afternoon.

The proposal is higher than the 1% increase given to providers in 2018.

The 1.8% payment update is based on an estimated 2.9% inpatient hospital market basket update, reduced by a 0.8% multi factor productivity adjustment and by a 0.3% adjustment set by the Affordable Care Act (ACA).


The proposed rule also includes regulatory language to reflect changes that were made in the Bipartisan Budget Act of 2018, which recognized physician assistants as attending physicians for Medicare hospice beneficiaries.

Under new proposals for revised data related to the Hospice Item Set (HIS), hospices would have 4.5 months after the end of each calendar year quarter to review and correct data that will be publicly reported, effective Jan. 1, 2019. HIS data is included on the Hospice Compare website.

CMS also plans to reduce some of the burden on providers regarding Hospice Compare by changing the display of the seven component measures from which a composite measure is calculated.


The proposed payment update also include an aggregate cap that limits the overall payment made to a hospice annually. The cap amount for 2019 will be a 1.8% increase, as well, to $29,205.44.

Hospice care, unlike home health care, has seen consistent reimbursement increases over the last several years. The number of Medicare beneficiaries receiving hospice services has grown from 513,000 in 2000 to nearly 1.5 million in 2017, according to CMS. Hospice expenditures are anticipated to continue rising 8% annually as more beneficiaries utilize the care.

Find the proposed rule here.

Written by Amy Baxter

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