The Q4 2022 Hospice Quality Reporting Program (HQRP) Update has been posted to the HQRP Requirements and Best Practices webpage. As a reminder, the HQRP Quarterly Update will no longer be posted. Instead, it will be distributed via email and providers can sign up for the quarterly informational emails at QRPHelp@swingtech.com Also, a reminder that…
Providers can now access the latest Provider Preview Reports via the Certification and Survey Provider Enhanced Reports (CASPER) application. Once released in CASPER, providers will have 30 days during which to review their quality measure results. Although the actual “preview period” is 30 days, the reports will continue to be available for another 30 days,…
PROVIDER PREVIEW REPORTS Hospice data in Care Compare will be refreshed in November. Hospices can now access the Provider Preview Reports for this refresh via the Certification and Survey Provider Enhanced Reports (CASPER) application. Once released in CASPER, providers will have 30 days during which to review their quality measure results. Although the actual “preview…
The hospice quality reporting program (HQRP) quarterly update has been recently posted, including a reminder that the HQRP annual payment update penalty for providers not compliant with calendar year 2022 submission requirements jumps from two percent to four percent.
In addition, there are updates related to public reporting, Q&A, and new HQRP resources among other updates. In addition to the quarterly update, there are a few items of note related to the HQRP.
- Hospices are reminded that the Hospice Visits in Last Days of Life (HVLDL) and the CAHPS Hospice Survey Star Rating will be posted to Care Compare this month. As reported previously, these measures were to be publicly reported in May of this year but were delayed due to an error in the provider preview reports.
- The HVLDL was formally endorsed by the National Quality Forum (NQF) at the end of July. NAHC and others submitted comments to the NQF about concerns with the HVLDL, primarily that it does not represent the care being provided to beneficiaries since it includes only RN and SW visits and does not include telehealth visits. We included concerns in our comments to the NQF about the data used by the Centers for Medicare and Medicaid Services (CMS) in deciding which types of visits should be included in the measure. While NQF ultimately endorsed the measure it recommended that CMS continue to develop the measure. Comments submitted that highlighted the concerns about the measure were an important component to this recommendation. NAHC also shared concerns about the HVLDL in the response to the FY2023 hospice proposed wage index and payment update and quality reporting program update rule. CMS acknowledged the comments in the final rule and indicated it is considering these comments.
- Notification to non-compliant hospice providers based on their CY 2021 quality data impacting FY 2023 payments was disseminated in July. Providers can find the notifications in their CASPER folders and should receive a notification from their Medicare Administrative Contractor (MAC). Providers have thirty (30) days from the date on the notification of non-compliance to submit a request for reconsideration. More information on the timeline for this process can be found in the quarterly update and on the CMS HQRP Reconsideration Requests webpage.
- Hospices are reminded that the Hospice quality reporting data submitted in CY 2022 data, starting on January 1, 2022 impacts FY 2024 payments. Beginning with FY 2024, the APU penalty doubles, going from 2% to 4%, for hospices not meeting the HQRP requirements. To ensure hospices achieve the full APU, be certain to meet the quality reporting requirements for data submission in CY 2022:
|Annual Payment Update||HIS||CAHPS|
|FY2024||Submit at least 90 percent of all HIS records within 30 days of the event date (patient’s admission or discharge) for patient admissions/discharges occurring 1/1/22 – 12/31/22.||Ongoing monthly participation in the Hospice CAHPS survey 1/1/2022 – 12/31/2022|
Most hospices that receive the APU penalty do so because of noncompliance with the Hospice Item Set (HIS) submission requirements. This frequently occurs during changes in EHR systems and changes in staffing so hospices should be sure to confirm submission of the HIS timely by downloading the Final Validation Reports. This report identifies HIS submissions received by CMS, and this receipt must occur in order for the hospice to receive “credit” for having submitted the HIS.
5. CMS has added some new resources for the HQRP which are below. CMS also indicated that it plans to host a Forum in September, but no dates have been provided yet. Stay tuned to NAHC Report for more information as it becomes available.
A) Hospice Care Index (HCI) Explanatory Video: CMS has developed a new video resource explaining the purpose and design of the claims-based HCI quality measure. This video provides an overview of the new HCI claims-based measure, which combines several quality indicators into a single index score.
B) HQRP Explanatory Video: The video introduces the purpose of the HQRP, how data is collected for use in HQRP, and the quality measures included in HQRP.
The hospice quality reporting program (HQRP) quarterly update has been recently posted, including a reminder that the HQRP annual payment update penalty for providers not compliant with calendar year 2022 submission requirements jumps from two percent to four percent. In addition, there are updates related to public reporting, Q&A, and new HQRP resources among other…
During the Centers for Medicare and Medicaid Services (CMS) Home Health, Hospice, and DME Open Door Forum on June 29, 2022, CMS reminded hospices that the August refresh of Care Compare will include the two new claims-based measures – Hospice Visits in Last Days of Life and Hospice Care Index. These measures were slated to be publicly reported with the May refresh of Care Compare but this was pushed back to August due to errors in the Provider Preview Reports for these measures issued in March. Therefore, hospices are to disregard the preview reports for March. Corrected preview reports are available now.
The reconsideration period for the FY2023 annual payment update (APU) hospice quality reporting program (HQRP) requirements is coming up. Hospice providers will receive notification from their Medicare Administrative Contractor (MAC) if they are subject to the APU penalty, and they will also receive notification in their CASPER folder.
Several new resources are scheduled to be posted to the HQRP website soon. These include the latest quarterly communication as well as new video resources that provide an overview of HQRP and an explanation of the HCI measure. CMS is also planning to release a technical report on the HCI. Stay tuned to NAHC Report for more information as these items become available.
There was some concern expressed by hospice participants in the ODF that the Care Compare website currently reflects that data for the HCI and HVLDL is suppressed upon request from the agency. This is not accurate as CMS suppressed the data due to an error in the preview reports, as stated above. CMS indicated that there is an additional update to the footnotes that will be pushed out soon and should provide some additional clarity on this situation for the public.
Last month, the Centers for Medicare & Medicaid Services (CMS) announced that the Hospice Visits in the Last Days of Life (HVLDL) and the Hospice Care Index (HCI) claims-based measures were not publicly displayed as planned in the May 2022 refresh. NAHC reached out to CMS about this and learned that there were technical errors in the data calculation, which were discovered well after the Preview Reports for these measures were released to hospices in March.
CMS is mandated to give providers a full 30 days to review the Preview Reports. Because of this, there was not time to re-release Preview Reports prior to the planned May 2022 refresh. Hospices should disregard the Preview Reports released in March for the HVLDL and HCI.
CMS is targeting the August 2022 refresh for the inaugural display of these quality measures and announced that new Provider Preview Reports for the HVLDL and HCI are now available in hospice’s CASPER (Certification and Survey Provider Enhanced Reports) folder.
Hospices utilized data from the incorrect scores in the Preview Reports to plan for performance improvement and they may have to adjust their priorities and plans now that the new Preview Reports are available.
The recently available provider Preview Reports also contain the Preview Reports for other publicly reported measures that will be updated in the August 2022 Care Compare refresh. These include the CAHPS Hospice Star Rating and the HIS Comprehensive Assessment measure.
Once released in CASPER, providers will have 30 days during which to review their quality measure results. Although the actual “preview period” is 30 days, the reports will continue to be available for another 30 days, or a total of 60 days. The preview period for the latest Provider Preview Report lasts from May 25, 2022 to June 27, 2022.
CMS encourages providers to download and save their Hospice Provider Preview Reports for future reference, as they will no longer be available in CASPER after this 60-day period.
Last month, the Centers for Medicare & Medicaid Services (CMS) announced that the Hospice Visits in the Last Days of Life (HVLDL) and the Hospice Care Index (HCI) claims-based measures were not publicly displayed as planned in the May 2022 refresh. NAHC reached out to CMS about this and learned that there were technical errors…
This article covers only the hospice portion of the most recent CMS Open Door Forum. To read about the home health portion, please see this NAHC Report article.
During the most recent Centers for Medicare & Medicaid Services (CMS) Home Health, Hospice, and DME (Durable Medicare Equipment) Open Door Forum (ODF), the following information and updates were provided.
CMS reminded hospices that the FY2024 annual payment update is based on the CY2022 data submissions. Hospices must comply with the following HIS and Hospice CAHPS Survey participation requirements to avoid the APU penalty which increases to 4% in FY2024.
- Submit at least 90% of HIS records within the 30 days of the event date (patient’s admission or discharge) for patient admissions/discharges occurring 1/1/22 – 12/31/22
- Ongoing monthly participation in the CAHPS Hospice Survey 1/1/22 – 12/31/22
The February 2022 quarterly refresh for the Hospice Quality Reporting Program is now available on Care Compare. Public reporting of quality measure data has resumed following the temporary exemption to HQRP data submission requirements, and the subsequent data freeze after the November 2020 refresh. Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Survey measure scores continue to exclude Quarter 1 and Quarter 2 of calendar year 2020.
In December 2021 CMS released revised data for the Hospice Care Index (HCI) in the hospice level Quality Measure (QM) reports available to hospices in their CASPER folder. CMS identified an issue with the national averages calculations and corrected these in the reports.
CMS is targeting the Care Compare refresh in May 2022 for public display of the HCI and Hospice Visits in Last Days of Life (HVLDL) claims-based measures.
Hospices can access resources available to them regarding the Hospice Quality Reporting Program (HQRP) here.
- CAHPS Star Rating
- CASPER toolkit
- HIS, HCI, HVLDL
A CAHPS Hospice Survey Star Rating will be added to Care Compare for hospices with the August 2022 refresh. How the star rating is calculated, what will be publicly reported, and information about the current “dry run” and provider preview information are part of the overview. Stay tuned to NAHC Report for member resources on the CAHPS Hospice Survey Star Rating.
The Centers for Medicare & Medicaid Services (CMS) conducted an overview of the star rating in a webinar on December 16, 2021 and the materials from the webinar – slide deck, transcript, and recording — are now available here.
CMS also updated and rebranded a provider toolkit for hospices, Getting Started with Hospice CASPER Quality Measure Reports: February 2022. The toolkit is to assist hospice providers in understanding and using the CASPER Quality Measure (QM) Reports that now include claims-based measures. There are two reports:
- The Hospice-Level QM Report includes the HIS Comprehensive Assessment at Admission (NQF #3235), HCI, and HVLDL measure scores.
- The Hospice Patient-Level QM Report identifies each patient with a qualifying HIS record used to calculate the hospice-level quality measure values for a select period.
The reports are detailed, and hospices may be especially interested in the Hospice Care Index (HCI) and Hospice Visits in Last Days of Life (HVLDL) information.
NAHC conducted a webinar on these measures in December where we reviewed the most frequently asked questions about the HVLDL and explained the HCI – each of its ten indicators, calculation of the index score, and expected performance for each of the indicators and the index. Information from the webinar and from a hospice’s QM reports are helpful for performance improvement. The recording of the webinar is available here.