Home Health & Hospice Week

Expect to see Medicare stick to its plan to finalize its forthcoming Special Focus Program next year. The program targets poor-performing hospices for increased survey scrutiny.

A Centers for Medicare & Medicaid Services official provided an update on hospice SFP activities in the Dec. 7 Open Door Forum for home health and hospice agencies.

Reminder: After scathing reports from the HHS Office of Inspector General on hospice quality of care and high-profile scrutiny from news outlets, CMS proposed a vast array of survey changes ranging from enforcement remedies to surveyor qualifications to this new targeting program. CMS had to include the proposal in the 2022 home health rulemaking cycle to meet statutory deadlines. In the November 2021 final home health rule, most of the proposed changes went through without modification. But CMS did hold off on the SFP.

Then in the 2023 hospice final rule issued this past July, CMS said “we have decided to initiate a hospice Technical Expert Panel (TEP) in CY 2022. Accordingly, CMS plans to use the TEP findings to further develop a proposal on the methodology for establishing the hospice SFP, and we plan to include a proposal implementing an SFP in the FY 2024 Hospice Wage Index and Payment Rate Update proposed rule.” That rule is expected out in April 2023, in about four months.

CMS contractor Abt Associates held the TEP this fall, the CMS staffer revealed in the forum. Topics discussed included the algorithm and methodology to identify poor-performing hospices, SFP survey frequency, utilization of technical assistance, graduation criteria, termination criteria, and public reporting, he relayed.

Next, CMS is holding a series of small group listening sessions this month for different stakeholders, the CMS source added. That includes one for hospice industry members, one for accrediting bodies, and one for patient and caregiver advocates.

CMS plans to issue a report summarizing the TEP and listening session discussions next year, the CMS speaker said. Then the agency will initiate rulemaking on the topic.

Do this: However, hospices don’t have to wait on official rulemaking to share their thoughts with CMS on how the program should be structured. Providers can send feedback for CMS consideration to QSOG_Hospice@cms.hhs.gov, the speaker offered.

Other hospice topics addressed in the forum include:

• HOPE tool. News is coming on the Hospice Outcomes and Patient Evaluation instrument. CMS will hold a quality forum in March that will contain an update, a CMS official told forum attendees.

Reminder: CMS and volunteer hospices completed final testing of the draft tool this fall.

• Care Compare. The next refresh for hospices on the quality website will be in February, CMS reminded. Preview reports for that updated data have been in hospices’ CASPER folders since Nov. 4.