Author: Tom Maxwell
Posted Date: August 1, 2023
The Centers for Medicare & Medicaid Services (CMS) has issued the Fiscal Year 2024 Hospice Payment Rate Update Final Rule (CMS-1787-F), outlining several critical provisions that will impact hospices in the upcoming year. Additionally, CMS is developing the Hospice Outcomes & Patient Evaluation (HOPE) assessment tool to enhance patient care and outcomes. For hospice providers seeking guidance on navigating these changes, Maxwell Healthcare Associates is here to provide valuable insights and support. Let's explore the key provisions and the HOPE assessment tool while understanding how Maxwell Healthcare Associates can assist in this evolving healthcare landscape.
The final rule implements a 3.1% payment rate update for hospices in FY 2024. This increase is estimated to result in a substantial $780 million rise in payments compared to FY 2023. The update is based on a 3.3% inpatient hospital market basket update, reduced by a 0.2 percentage point productivity adjustment.
For FY 2024, the hospice aggregate cap is set at $33,494.01. This cap limits the total Medicare payments a hospice can receive in a given year and is calculated by multiplying the cap amount by the number of Medicare beneficiaries served.
Here is a summary over the past 10 years of the cap changes.
Hospices must meet quality reporting requirements to ensure continued favorable payment updates. The final rule confirms a 4-percentage point reduction in the annual payment update for hospices failing to meet these requirements, doubling the previous penalty of 2 percentage points.
Effective from May 1, 2024, the final rule mandates physicians certifying hospice eligibility to be enrolled in or opted out of Medicare. This measure aims to strengthen oversight and prevent fraudulent practices, ensuring that only qualified and authorized physicians can certify hospice eligibility.
The rule includes conforming changes to regulations regarding telehealth for routine home care after the end of the Public Health Emergency (PHE). Temporary expansions made during the PHE will be removed, potentially impacting telehealth service provisions in hospice settings.
The CMS considered public comments on various topics, including the provision of care, spending patterns, ownership transparency, informing patient choice, and examining equity. These comments will shape future policy making in these critical areas.
The HOPE assessment tool is a new patient-level data collection tool being developed by CMS to assess the care needs, preferences, and outcomes of hospice patients. It aims to collect standardized data to inform quality measures, capturing care processes, interventions, and outcomes across diverse settings.
HOPE will encompass critical components such as hospice admission, updates during skilled nursing visits, goals, care processes, outcomes during stays, and discharge. By providing a comprehensive, longitudinal view of patients throughout their hospice journey, the tool will enable better evaluation and improvement of the overall quality of care delivered.
The collected data points will be extensive, including patient goals, symptoms, treatments, medications, discipline visits, transitions, caregiver needs, and satisfaction. This in-depth information will empower hospice providers to tailor care according to individual patient needs.
CMS will conduct pilot testing to evaluate the effectiveness and practicality of HOPE before its widespread implementation. Future rulemaking will address reporting requirements and the potential impact on payment methodologies, demonstrating CMS's commitment to using HOPE data to drive quality improvement in hospice care.
The FY 2024 Hospice Payment Rate Update Final Rule introduces critical changes in hospice care, impacting payment rates, quality reporting, physician certification, telehealth regulations, and more. Concurrently, the development of the HOPE assessment tool holds promise for enhancing patient care and outcomes through comprehensive data collection and patient-centric evaluation.
To navigate these changes effectively and ensure compliance, hospice providers can rely on the expertise of Maxwell Healthcare Associates. With a deep understanding of healthcare consulting and the evolving regulatory landscape, MHA can provide valuable insights and support. By partnering with MHA, hospice providers can embrace the changes, stay informed, and continue delivering exceptional care to those in need of hospice services.
Together, we can navigate change and ensure high-quality care for all hospice patients. Embrace these changes, stay informed, and partner with industry experts to make a meaningful difference in the lives of patients and their families during their end-of-life journey. For more information and to stay connected with Maxwell Healthcare Associates, visit www.maxwellhca.com or contact us at [email protected]. Together, we can continue to provide compassionate and comprehensive hospice care.