NEW Hospice Provider Preview Reports

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.

NEW Hospice Provider Preview Reports

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…

NAHC Urges CMS to Collect Data on Technology-based and Chaplain Visits

Prior to the COVID-19 Public Health Emergency (PHE) many hospice providers had significant success with use of technology-based visits; however, there were a number of hospices that did not utilize technologies to their fullest extent because they believed they were required to provide all visits in-person. Early in the PHE, the Centers for Medicare & Medicaid Services (CMS) communicated that hospices are permitted to use telecommunications technologies to deliver hospice visits provided that such visits and technologies are specified by the Interdisciplinary Team (IDT) on the plan of care and that the goals of care (as outlined) are met.

In response to CMS’ clarification, hospice providers throughout the nation began to utilize technology more broadly in hospice care delivery, and found that, when used appropriately, this mode of care can provide substantial benefits to patients, family members, and hospice staff. However, CMS instructed hospices to not report these visits on hospice claims, which raised significant concern that CMS would not have accurate information on the full scope of services being provided to hospice patients, and that CMS and others would have no way of determining the impact that use of telecommunications technologies has on the quality of hospice care. The National Association for Home Care & Hospice (NAHC) has communicated to CMS a number of times since the start of the PHE that data on hospice “virtual” visits should be collected.

On a related matter, CMS has never required collection of data on chaplain visits on hospice claims, although previously, when the Hospice Item Set (HIS) data was directly submitted by hospice organizations and CMS gathered date for the Hospice Visits When Death is Imminent (HVDII) measure pair, the number of chaplain visits delivered during the last seven days of life was collected. The HVDII measure pair has been replaced with a claims-based measure (Hospice Visits in the Last Days of Life), which does not assess chaplain visits. As chaplains are essential members of the hospice IDT and the provision of chaplain services is a distinguishing element of the hospice benefit, NAHC and others have strongly urged CMS to collect data on chaplain visits on claims.

During the January 2022 meeting of the Medicare Payment Advisory Commission (MedPAC), the Commission approved a recommendation that the Secretary of Health & Human Services collect data on telehealth visits going forward as long as the agency permits telehealth visits in hospice. In putting forth the recommendation for the MedPAC March 2022 Report to Congress, Commission staff noted that, “Requiring hospices to report telehealth visits would increase the program’s ability to monitor beneficiary access to care.”  MedPAC’s recent action prompted the national hospice associations  (NAHC, NHPCO, LeadingAge, and NPHI) to join together in a letter to CMS Administrator Chiquita Brooks-LaSure urging that CMS:

  • Implement a modifier or HCPCS code and create a field on the hospice claim for telehealth visits from any discipline, to more accurately represent the full range of visits that hospices provide
  • Take the necessary steps to establish a HCPCS code specifically for chaplains in hospice and require reporting of chaplain visits on claims

The full letter to Administrator Brooks-LaSure is available HERE.  NAHC will provide updates on this and related issues in future issues of NAHC Report.

NAHC Urges CMS to Collect Data on Technology-based and Chaplain Visits

Prior to the COVID-19 Public Health Emergency (PHE) many hospice providers had significant success with use of technology-based visits; however, there were a number of hospices that did not utilize technologies to their fullest extent because they believed they were required to provide all visits in-person. Early in the PHE, the Centers for Medicare &…

Hospice Quality Reporting Program Updates

Important Nov 30 webinar on this topic! There are several new documents and updates for the Hospice Quality Reporting Program (HQRP) that hospices should be aware of as the new reporting year quickly approaches.  These are outlined below. In addition to these updates, NAHC will answer all your questions about this topic in a new…

Hospice Quality Reporting Program Update: HIS Timeliness Compliance Threshold Report

Hospices can now access their confidential Quality Measure (QM) reports in CASPER for two new publicly reported measures, Hospice Care Index (HCI) and Hospice Visits in the Last Days of Life (HVLDL).  These two claims-based measures will be publicly reported on Care Compare no sooner than May 2022. Hospices have been anxiously waiting to see…

CMS Wants Recruits for the Hospice Outcomes & Patient Evaluation Beta Test

APPLY BY JUNE 14 APPLICATION IS HERE The Centers for Medicare & Medicaid Services (CMS) and Abt Associates are recruiting Medicare-certified hospices for the HOPE beta test. The detailed announcement and application are attached and located on the HQRP Provider & Stakeholder Engagement webpage. CMS plans to include hospices from each of the four Census…

Hospice Visits in Last Days of Life Measure Clarified

The Centers for Medicare & Medicaid (CMS) has re-specified the Hospice Visits When Death is Imminent (HVWDII) measure. The re-specified measure, Hospice Visits in Last Days of Life (HVLDL), and was announced by CMS via the report Hospice Visits When Death is Imminent: Measure Validity Testing Summary and Re-Specifications (posted in September, 2020). HVLDL is a…

New CMS Webinar: What You Need to Know About Changes in the Hospice Item Set Manual

The Centers for Medicare & Medicaid Services (CMS) will be hosting a webinar on Thursday, April 15, 2021 from 2:00 to 3:30 p.m. ET. The purpose of this training is to provide a general overview of the changes included in the Hospice Item Set (HIS) Manual V3.00. Specific topics include: The Hospice Quality Reporting Program…

Hospice Item Set and Manual Updated, 2020 Hospice Technical Expert Panel Report Posted

The final Hospice Item Set (HIS) Manual V3.00 is now available, as is the updated HIS-Admission and HIS-Discharge documents. The updates to the HIS Manual and HIS-Discharge instrument reflect the removal of Section O and associated measures.  The HIS-Admission instrument was updated to reflect the current reporting year dates.  These changes were made to accommodate…