The proposed rule also would change the quality reporting program for hospices, under which they began to face penalties in fiscal 2013. The rule proposed that beginning in fiscal 2016 hospices’ would replace reporting on a pain management measure and a structural measure with two other measures.
Also in fiscal 2016, the CMS proposed requiring hospices to collect and submit new patient-data forms. The Hospice Item Set would aim to track standardized aspects of hospice patient care at admission and discharge. Data collection would begin July 1, 2014, and affect payments beginning in fiscal 2016.
A new quality-reporting requirement of the rule proposed for fiscal 2017 is a hospice experience-of-care survey for families and friends of hospice patients. The survey would track hospice provider communications with patients and families; hospice provider care; and overall rating of hospices. The CMS plans to include the final requirements for that survey in its fiscal 2015 rulemaking.
Additionally, the proposed rule includes updates on Medicare hospice payment reform efforts, including a discussion of reform model options; highlights from recent reform research; and an update on data collection efforts.
The latest rates come amid rapid growth in Medicare beneficiary use of hospices from 513,000 in fiscal 2000 to more than 1.3 million in fiscal 2012. Similarly, CMS spending on hospices has risen sharply from $2.9 billion in fiscal 2000 to $14.7 billion in fiscal 2012.
The increase is partly due to an increased average length of stay for beneficiaries, according to the CMS, from 54 days in 2000 to 86 days in fiscal 2010, up nearly 60%.Read more: