Home Health & Hospice Week

More data collection surrounding health equity may be on the horizon.

Medicare is weighing a number of changes to the hospice landscape both large and small, and now is your window to give feedback on them.

The Centers for Medicare & Medicaid Services wraps up the statistical section of its 2024 proposed payment rule with a solicitation for comments on a wide number of fronts, including:

• Levels of care. “We anticipated that rebasing the payment rates for these three levels would result in an increase in utilization; however … this has not been the case,” CMS notes.
• Non-hospice spending for hospice patients. “What are reasons why non-hospice spending is growing for beneficiaries who elect hospice?” CMS asks.
• Election decisions. Should the Patient Notification of Hospice Non-Covered Items, Services, and Drugs “be provided to all prospective patients at the time of hospice election or as part of the care plan?” the rule inquires.
• Ownership data. CMS wants to know the best way to get that into patients’ hands (see story, p. 114).
• Health equity. “Health inequities persist overall in hospice and palliative care, where Black and Hispanic populations are less likely to utilize care and over 80 percent of patients are White,” CMS highlights in the rule. “After hospice admission, some studies have shown that minorities experience disparities in the quality of care, with some evidence of higher rates of hospice disenrollment and concerns about care coordination amongst hospices with a higher proportion of Black enrollees.” CMS is looking for “input regarding the potential collection of additional indices and data elements that can provide insight regarding underlying health status and non-medical factors, access to care, and experience in medical care,” it says.

Of course, HHAs will want to comment on reimbursement rates and other rule elements as well.

“We believe the information gathered under this RFI would help to improve the continuum of care under the hospice benefit by: (1) heightened patient and family satisfaction; (2) improvement in quality indicators; (3) lower rates of hospitalization (to include decreased intensive care unit admission and invasive procedures at the end of life); and (4) significantly lower health care expenditures at the end of life,” CMS says.

Note: Comments are due by May 30. Submit electronic comments at www.regulations.gov/document/CMS-2023-0051-0002 using the “Comment” button.