Implications of the Final Rule for Hospice Agencies

In the previous section, we reviewed the most recent final rule released by the Centers for Medicare and Medicaid Services (CMS) issued for 2022. In this section, we will discuss the implications of the final rule for hospice agencies. Remaining in compliance with these new rules is essential for hospice agencies to receive full and complete compensation for care provided to their patients. A tighter focus has been placed on measuring the quality of care as well as how quality will be reported to the CMS. The CMS has also released a Webinar on the final rule as well as full documentation provided on their website. ‍

Increased Payment Cap 

One significant update that the final rule announced is a 2% increase in pay for hospice agencies that are approved to receive medicare funding. This equates to a $480 million increase in 2022. In addition, total payment caps were increased by $613.68 per patient from 2021 to 2022. 

Seven HIS Measures Removed 

The CMS has determined that the Hospice Comprehensive Assessment Measure is a much more broadly applicable way to measure quality of care than seven of the previously required HIS measures. While hospice agencies must still submit their individual HIS admission assessments, the Hospice Outcome and Patient Evaluation (HOPE) will likely be used to finalize the assessment. 

Updated Hospice Quality Reporting 

Two new claims based measurements were added to the system for evaluating the quality of care administered by hospice agencies in the final rule. One new composite measure includes 10 indicators of quality based on claims data. Some of these indicators focus on aspects such as rate of discharge, length of visit, transitions, etc. 

Introduction of Star Ratings as a Measure of Quality of Care 

Care Compare will now offer star ratings to the public for added transparency to make it easier for patients and caregivers to make the best decision for their care. The CMS wants to make it easier and more practical for people to compare the quality of care offered by different hospice agencies. 

Regulatory Text Changes

The Hospice Election Statement addendum requirements now have regulatory text changes set forth by the final rule. A few changes were made based on the experience of stakeholders and provider including the following: 

• Date clarification
• Timing of notices
• Addendum mailing
• Updated model election statement 
• Addendum requests made by non-hospice providers