Hospice, News, Payment/economy

Proposed 2019 hospice rule increases payments by $340 million

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Hospices are expected to receive a 1.8% payment increase in 2019 — an improvement from the prior year, according to the 2019 proposed hospice payment rule posted April 27 on the Federal Register.

Hospices only received a 1% payment increase in 2018. The lower amount in the prior year’s rule largely was due to a one-time reduction in the payment update due to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). To help pay for MACRA, hospices received 1% less in payments than they would have in 2018.

The $340 million payment increase is based on an estimated 2.9% inpatient hospital market basket update, reduced by a 0.8% multifactor productivity adjustment and a 0.3% adjustment due to the Affordable Care Act.

Rule explains increases for RHC
For hospices that submit quality data and provide routine home care (RHC), the payment rate for days one through 60 would be $196.25 in 2019, compared to $192.78 in 2018.

For days 61 and beyond, payments would be $154.21 in 2019, compared to $151.41 in 2018.

Continuous home care would pay $998.77, inpatient respite care would pay $176.01 and general inpatient care would pay $758.07.

Rural hospices in New England would experience the largest payment increase (3.3%) as a result of the rule, while rural hospices in the Mountain area only would experience a 1.4% payment increase.

More from the proposed hospice rule

  • CMS seeks feedback on solutions involving data sharing. The federal Medicare agency is releasing a Request for Information (RFI) “to obtain feedback on positive solutions to better achieve interoperability or the sharing of health care data between providers,” a CMS fact sheet about the rule states. “Specifically, CMS is requesting stakeholder feedback through a RFI on the possibility of revising Conditions of Participation related to interoperability as a way to increase electronic sharing of data by providers.”
  • Text changes due to Bipartisan Budget Act of 2018. Effective Jan. 1, 2019, physician assistants would be recognized as attending physicians for hospice beneficiaries.
  • New review and correction timeframes for data using the Hospice Item Set (HIS). To ensure data reported on Hospice Compare are accurate and to align with other post-acute quality reporting programs, CMS is seeking for hospices to have 4½ months after the end of each quarter to review and correct HIS data that will be reported publicly. This change would go into effect in 2019.
  • Public reporting of two quality measures. CMS is seeking to publicly report on the Hospice Compare website the HIS-based Hospice Comprehensive Assessment Measure (NQF #3235) and Hospice Visits when Death is Imminent Measure Pair. The 2017 hospice payment final rule created those quality measures.
Related links: Read the proposed rule at https://bit.ly/2jhdcAR and a fact sheet about the rule at https://go.cms.gov/2Hy15hi. Comment on the rule by no later than 5 p.m. EST June 26. Submit comments electronically at www.regulations.gov..