Payment Update

Current law sets forth a formula that guides CMS’ proposed payment update that can be changed if Congress passes legislation to change the existing formula. In the proposed rule the payment update for fiscal year (FY) 2020 is 2.7% based on the estimated inpatient hospital market basket update of 3.2% minus the multifactor productivity adjustment estimated at 0.5%. CMS indicates this to be a $540 million increase in payments. However, that is a simplistic overview of the payment adjustment for this rule as it affects hospice rates.

Hospice

Payment Update

The proposed payment update for FY 2020 is 2.7% based on the estimated inpatient hospital market basket update of 3.2% minus the multifactor productivity adjustment estimated at 0.5%. CMS indicates this to be a $540 million increase in payments. However, that is a simplistic overview of the payment adjustment for this rule as it affects hospice rates.

LeadingAge, LeadingAge Ohio, and the National Partnership for Hospice Innovation collaborated on the development of the report.

The publication describes the genesis of hospice services in the nonprofit sector and the growth of the sector following Medicare's expansion to cover hospice in the 1980s. As the report points out, hospice was the first type of health care service taking an interdisciplinary team approach to care, with payment bundled on a capitated basis.

CMS plans to begin displaying the first measure—which covers the last three days of a hospice patient’s life—on Hospice Compare in summer 2019 but will further test the second measure—which focuses on the last seven days of life—before any future display on Hospice Compare.

Hospice Visits when Death is Imminent is a pair of CMS hospice quality measures that assess hospice staff visits to patients at the end of life over 3 or 7 days.

During the LeadingAge Leadership Summit in Washington, DC, last week, Centers for Medicare & Medicaid Services (CMS) was on hand to meet with nursing home providers and present a Skilled Nursing Regulatory Update. Topics included survey trends, a brief overview of the analysis that heralded the reinstatement of the health inspection star rating to the 5-Star Quality Rating System, changes to the 5-Star Quality Rating System, and the Patient-Driven Payment Model (PDPM).

The Administration for Community Living (ACL) has offered grant funding to states and community-based programs to build and expand home and community-based services (HCBS) specifically for people with dementia since 2014. The purpose of these funds has been to develop models of home and community-based care for people living with dementia, including Alzheimer’s, and ultimately to identify models that could help realize a dementia-capable HCBS system.


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