Home Health & Hospice Week

Hospice-specific market basket needed, according to proposal.

In an unwelcome switch for hospice providers, the rate of proposed cuts for Medicare hospice payment outstrip those for home health agencies in the Obama administration’s 2017 budget proposal. But they would be over quicker.

President Obama issued his last budget proposal on Feb. 9, and it calls for a 1.7 percent reduction to the hospice payment update in 2018-2020. Those cuts would merely be “a first step toward aligning payment with costs of care” in hospice, according to a Department of Health & Human Services summary of the budget.

The budget proposal also calls for the Centers for Medicare & Medicaid Services to implement a “hospice-specific market basket” by 2021. “Currently, the hospice market basket is based on the hospital market basket, despite differences in the type of service provided (palliative vs. curative), the care setting (at home vs. inpatient), and the labor force utilized,” the budget summary explains.

More changes ahead: The proposal also calls for HHS to make unspecified “further budget neutral reforms to the hospice payment system.”

Those payment changes together would slice $9.3 billion from Medicare hospice spending during that time, the president estimates.

“Congress should oppose any reductions in the annual updates until such time as all payment reforms are instituted and then only after the impact of such changes are fully examined,” protests the National Association for Home Care & Hospice in its Legislative Blueprint for Action.

Note: See the 173-page HHS summary of the budget proposal at www.hhs.gov/about/budget/fy2017/budget-in-brief/index.html.