Hospice Item Set: What You Should Know

HIS Preparation.

Beginning July 1, 2014, hospices will be required to begin using the Hospice Item Set (HIS) for all patients for all patients admitted to hospice, regardless of payer, age, or location. This will have a payment impact in FY 2016. Hospices that fail to comply will be subject to a two-percent (2%) reduction in their Annual Payment Update (APU) for the fiscal year. With this requirement comes significant administrative burden which can put your agency at risk for non-compliance if not managed properly. Hospices will need to begin to prepare now for this new reporting.

What is the Hospice Item Set (HIS)?
Implemented as part of the FY 2014 Hospice Wage Index Final Rule, the HIS is a set of data elements that are used to calculate the following quality measures:

  • NQF #1641: Treatment Practices
  • Modified NQF: #1637: Beliefs/Values Addressed
  • NQF #1634 & #1637: Pain Screening and Pain Assessment
  • NQF #1638 & #1639: Dyspnea Screening and Dyspnea Treament
  • NQF #1617: Patients Treated with an Opioid who are Given a Bowel Regimen

The HIS is not a patient assessment tool, but rather a standardized tool for abstracting data from the clinical record. It is not administered directly to the patient or family.

Who must submit HIS?
All Medicare-certified hospices must submit. Data should be collected and submitted on all admissions for patients age 18 years and older.

What data is submitted?
Hospices will be required to submit two HIS records for each patient admitted: a HIS-Admission record and HIS-Discharge record. These records are to be submitted electronically to CMS on an ongoing basis.

How should hospices implement the HIS?
One method of implementation involves matching items currently in your clinical record or patient assessment forms to items in the HIS. Most hospice software vendors, including HEALTHCAREfirst will provide the ability to capture the data items necessary for extraction and submission. Additionally, HEALTHCAREfirst offers Quality Actionboards that guide hospices through HIS data capture, interpretation, and integration of results for adept management of clinical processes and quality outcome measures.

For additional information about the Hospice Item Set, hospices should visit CMS’ Hospice Quality Reporting page.