Home Health & Hospice Week

Quality reporting, CAHPS also addressed at recent industry conference.

Centers for Medicare & Medicaid Services officials couldn’t divulge any information on Medicare’s plans for hospice cost reform, but they did pledge at a recent industry conference that they were hard at work on the issue.

Background: Congress gave CMS authority to implement hospice payment reform in October 2013 or later. But whether CMS will even make October 2014 (the start of the 2015 fiscal year) is still in question.

CMS can’t discuss payment reform or what’s in the FY 2015 rule, noted the agency’s Hillary Loeffler in the National Association for Home Care & Hospice’s March on Washington conference on March 24.

At last year’s March on Washington conference, CMS officials said the lack of cost report and claims data was making crafting payment reform challenging. Now, CMS is crunching the numbers on the increased data it’s received (see related story, this page).

CMS may want to wait until it starts receiving the vastly increased claims data required as of April 1 before it reaches a final payment reform proposal, observers predict.

Reminder: The Medicare Payment Advisory Commission has recommended a new U-shaped payment methodology, where hospices would receive higher reimbursement at the beginning and end of a patient’s stay and less in the middle days. Another model floated would be a J-shape, with slightly higher reimbursement at the beginning, less in the middle, and the highest at the end of care.

Other hospice issues raised in the NAHC forum include:

• Cost reports. Cost report changes for freestanding hospices are on deck, Loeffler said in the CMS hospice panel session. Watch for a transmittal this month. Changes for hospital- and home health
agency-based hospices will come later, NAHC notes in its member newsletter.

The cost report will take effect for cost report years beginning Oct. 1, 2014, or later. CMS issued several proposed versions of the report, with the latest in November (see Eli’s HCW, Vol. XXII, No. 42). Numerous form changes are expected to support the new requirement to break down costs by each of the four levels of care: continuous, routine, inpatient respite, and GIP.

Watch out: “Level 1 and Level 2 edits will be implemented … to help ensure great accuracy of cost reporting,” NAHC believes.

• CAHPS. Hospices’ Consumer Assessment of Healthcare Providers and Systems surveys are just around the corner. Hospices’ vendors will start data collection next January, CMS’s Debra Dean-Whittaker told conference attendees. The dry run period will from from January to March, then hospices’ vendors must collect monthly data starting in April 2015.

Remember: If you fail to arrange for a vendor to collect and report your data next year, you’ll see payment rates reduced by 2 percent in fiscal year 2017, Dean-Whittaker reminded hospices.

CMS and its CAHPS contractor hope to post the hospice CAHPS vendor list by this summer, Dean-Whittaker added. A date for public reporting of the CAHPS data has not yet been set, she said.

• Quality reporting. If you fail to live up to your hospice quality reporting program duties, you’ll be in the minority. Ninety-three percent of hospices successfully reported quality data in 2014, said CMS’s Mary Pratt in the conference.