Home Health & Hospice Week

A sea change in how Medicare will pay for hospice begins this month. The Centers for Medicare & Medicaid Services will begin collecting quality data for hospices, although at this point the collection is voluntary.

Background: In its fiscal year 2012 payment rule for hospices, CMS required pay for reporting in 2013 (see Eli's HCW, Vol. XX, No. 28, p. 217). But CMS instituted voluntary reporting starting this month. "Voluntary reporting of the structural measure data with specific quality indicators ... would allow us to learn what the important patient care quality issues are for hospices and would serve to provide useful information in the design and structure of the quality reporting program," CMS explains in the rule.

Hospices have until Jan. 31 to report data on a web-based form newly approved by the Office of Management and Budget, said CMS's Robin Dowell in the Jan. 11 Open Door Forum for home care providers. The form is available via www.cms.gov/LTCH-IRF-Hospice-Quality-Reporting/10_HospiceQualityReporting.asp -- scroll down to the "Related Links Outside CMS" section.

Remember: You don't actually have to submit any numerical data during the voluntary reporting period, Dowell reminded forum listeners. The new form just asks whether you had a QAPI program with three patient-care related indicators in thethird quarter of 2011, and what those indicators are, she related.

CMS is encouraging all hospices to voluntarily submit data, Dowell said.

Starting in 2013, hospices must report one pain management quality measure in addition to the structural QAPI measure. The required quality measure is National Quality Forum Measure #0209, "Percentage of patients who were uncomfortable because of pain on admission to hospice whose pain was brought under control within 48 hours."

And the 2013 reporting will have an impact on reimbursement. Hospices' 2014 reimbursement rates will be cut by 2 percent if they don't report the quality data, CMS says in the rule.

The required reporting next year is just the beginning, experts predict. "Our intent is to require additional standardized and specific quality measures to be reported by hospices in subsequent years," CMS says in the rule at www.gpo.gov/fdsys/pkg/FR-2011-08-04/pdf/2011-19488.pdf.