On August 1, 2018, CMS issued the FY2019 Hospice Final Rule for Medicare hospice agencies. The final rule includes changes to the hospice payment rates as well as updates to the Hospice Quality Reporting Program (HQRP).

Burden Reduction

CMS will no longer display the seven component measures from which a composite measure is calculated on Hospice Compare. CMS is reformatting the display of the component measures so that they are only viewable in an expandable/collapsible format under the composite measure itself. This gives users the opportunity to view the component measure scores that were used to calculate the main composite measure score in a more efficient and less confusing manner.

Improved Transparency

The FY2019 Hospice Final Rule finalizes several procedural policies for hospice quality reporting, including a review and correction of timeframes for data submitted using the Hospice Item Set (HIS), an extension of the Hospice CAHPS survey participation requirements, and several public reporting policies and procedures.

The rule also includes updates and improvements to Hospice Compare to help consumers make an informed decision in their selection of a hospice including:

  • Public display of the HIS-based Hospice Comprehensive Assessment Measure (NQF #3235) and Hospice Visits when Death is Imminent Measure Pair
  • Reformatting of the public display of the current seven HIS quality measures
  • Inclusion of data as shown from the CMS Public Use Files (PUFs)

Meaningful Measures

CMS states in the FY2019 Hospice Final Rule that it is finalizing a measure removal factor that takes into consideration whether the costs and burden associated with a measure outweighs the benefit of its continued use in the program. It states that its goal is to, “move the program forward in the least costly and burdensome manner possible, while maintaining meaningful quality measures and continuing to incentivize improvement in the quality of care provided to patients.”

Annual Rate Setting Changes

Hospices will get a 1.8% ($340 million) increase in payments for FY2019. The hospice payment update percentage for FY2019 is based on a 2.9% inpatient hospital market basket update, reduced by a 0.8% point multifactor productivity adjustment and reduced by a 0.3 percentage point adjustment required by law. Hospices that fail to meet quality reporting requirements receive a 2.0 percentage point reduction to their payments.

The hospice payment system includes a statutory aggregate cap. The aggregate cap limits the overall payments made to a hospice annually. The cap amount for FY 2019 will be $29,205.44 (2018 cap amount of $28,689.04 increased by 1.8%).

Hospice Regulations Text Changes

The Bipartisan Budget Act of 2018 amended the Social Security Act so that, effective January 1, 2019, physician assistants are recognized as attending physicians for Medicare hospice beneficiaries. This expands the definition of a hospice attending physician to include physician assistants in addition to physicians and nurse practitioners. CMS states that it is finalizing changes to the hospice regulations to reflect that change.

The regulations are effective October 1, 2018. Click here to read the FY2019 Hospice Final Rule.

HEALTHCAREfirst hosted a webinar where we discussed the FY2019 Hospice Final Rule and what it means to hospices. Click here to view the webinar replay.

The HEALTHCAREfirst Difference

HEALTHCAREfirst offers hospice agencies solutions designed to keep you in compliance while allowing you to focus on patients, not paperwork. This includes hospice software, advanced hospice analytics, and Hospice CAHPS surveys.

Contact us to learn more!