Hospice Payment Rate Update for FY 2022

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

On April 8, 2021, CMS issued a proposed rule that would provide routine updates to hospice base payments and the aggregate cap amount for Fiscal Year (FY) 2022. This proposed rule also includes a comment solicitation regarding hospice utilization. In addition, this rule proposes to rebase the hospice labor shares and clarify certain aspects of the hospice election statement addendum requirements.

This rule proposes changes to the hospice conditions of participation and Hospice Quality Reporting Program (HQRP). The proposed rule also includes a Home Health Quality Reporting Program proposal to display publicly 3 quarters of certain outcome and assessment information set data due to the COVID-19 public health emergency exemptions of the 2020 first and second quarter data. 

As proposed, hospices would see a 2.3 percent ($530 million) increase in their payments for FY 2022. The proposed 2.3 percent hospice payment update for FY 2022 is based on the estimated 2.5 percent inpatient hospital market basket reduced by the multifactor productivity adjustment (0.2 percentage point). Hospices that fail to meet quality reporting requirements receive a 2-percentage point reduction to the annual market basket update for FY 2022.

Proposed updates include:

  • Hospice labor shares.
  • Fast health care interoperability resources in support of the HQRP – Request for Information (RFI).
  • Closing the health equity gap in the HQRP – RFI.
  • Changes to the hospice CoPs regarding hospice aide competency evaluation standards and proposing that hospices conduct a competency evaluation related to the deficient and related skill(s) noted during a hospice aide supervisory visit.
  • A new measure in the HQRP called the Hospice Care Index. This single measure includes 10 indicators of quality that are calculated from claims data.
  • Add Consumer Assessment of Healthcare Providers and Systems (CAHPS®), Hospice Survey Star ratings on Care Compare.
  • Addition of the claims-based Hospice Visits in the Last Days of Life (HVLDL) measure for public reporting. 

For more information, please reference the unpublished version (173 pages) which is scheduled for publication in the Federal Register on April 14, 2021.  Comments will be accepted by CMS until June 7, 2021.

The Fact Sheet provides additional information as does the CMS Hospice Center website.

I encourage you to review the proposed rule with your team and provide comment to CMS by the deadline.  Make your voices heard.