Helping you prepare and succeed in hospice

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HealthCarefirst is here for you. We want to make sure you’re equipped to handle the impact of the hospice finalized payment rate and wage-index changes your agency  might see in FY 2020 based on CMS simulated payment analysis.

The following payment provisions were finalized in the FY 2020 Hospice Payment Rate Update Final Rule (CMS-1714-F):

  • An estimated annual payment update of 2.6 percent.
  • Rebasing of the Continuous Home Care (CHC), Inpatient Respite Care (IRC), and General Inpatient (GIP) levels of care to better align Medicare payments with the costs of care.
  • Reduction   of the Routine Home Care (RHC) level of care to offset the rebased increases to CHC, IRC and GIP and maintain overall budget neutrality.
  • Use of the concurrent inpatient prospective payment system wage index for the computation of the hospice wage index to align with other settings of care (Elimination of the one-year lag).
  • A FY 2020 Aggregate Cap amount of $29,964.78.

The table below demonstrates the statistical analytics on the CMS simulated FY2020 payment impact using FY 2018 claims data with and without the one-year lag in wage index across all CCNs.

1 x% percentile means x% of agencies that had payment impact that is worse than the number displayed.

Use the tool below to get a projection of what the impact of the finalized hospice FY 2020 rate and wage index changes could be on your agency.

*The rate comparison provided within this tool is using the CMS published Hospice Provider-Level Impacts based on the FY 2020 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Requirements final rule. HealthCarefirst added calculations to the CMS published document to calculate the projected dollar amount and percentage reimbursement differences between the CMS simulated FY 2019 payments (before rebasing) and CMS simulated FY 2020 rebased payments, with and without the one-year lag as the basis for the Hospice wage index. This information is aimed to help agencies better identify the potential financial impact to their agency  and is to be used for informational purposes only, as these calculations should be individually verified by recipient. The source document can be found on the CMS website: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/Hospice/Hospice-Regulations-and-Notices-Items/CMS-1714-F.html.

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