New Target Area for Hospice PEPPER

The 2021 release of the Hospice Program for Evaluating Payment Patterns Electronic Report (PEPPER), anticipated spring  2021, will include at least one new target area – Average Number of Part D Claims per Hospice Episode.  This target area will measure the count of Medicare Part D claims for beneficiaries billed during hospice episodes in the…

MedPAC Discusses Future Directions in Hospice Payment Reforms

–Seeks Solution for Long-Stay Incentives and Troublesome Utilization Patterns On October 1, the Medicare Payment Advisory Commission (MedPAC) began discussions of future directions for hospice payment policy. Hospice has undergone payment changes in recent years, including creation of a two-tiered payment system for Routine Home Care (RHC) and more recent recalibration of payments between the…

MedPAC Finds Pandemic Devastated Nursing Homes, Assisted Living Facilities

Steep decline in home care services has mostly recovered. The Medicare Payment Advisory Commission (MedPAC) recently reconvened for a series of sessions in their continued efforts to optimize the Medicare program. Leading off the September meeting was a session focused on the effects of the COVID-19 pandemic on the Medicare program. As expected, the MedPAC…

Hospice Quality Reporting Program Revisions Proposed

The Centers for Medicare & Medicaid Services (CMS) is planning to revise the Hospice Quality Reporting Program (HQRP) measures and the Hospice Item Set (HIS) to remove Section O from the HIS and replace the Hospice Visits When Death is Imminent measure with a Hospice Visits in the Last Days of Life measure. Section O…

MedPAC Calls for Cuts to Home Health and Hospice

The Medicare Payment Advisory Commission (MedPAC) recommended a seven percent payment reduction to the base home health payment rate for 2021 and the elimination of the update to the FY2021 base payment rates for hospice, at their meeting on January 16. In past years the commission has recommended a five percent reduction in the home…

MedPAC Staff Recommend 7 Percent Cut in Medicare Payment to Home Health Providers

On December 5, the Medicare Payment Advisory Commission (MedPAC) convened for a session titled Assessing Payment Adequacy and Updating Payments: Home Health Care. This is an annual process where the commission receives a presentation evaluating payment adequacy for services rendered, as well as a report on patient access to home health services, and quality of…

Industry Trend Report Tracks Hospice Length of Stay, Utilization

In its 2019 Industry Trend Report, data analytics firm Trella Health (formerly Excel Health Group) provides timely insights into hospice trends, including a focus on hospice admissions, utilization, and length of stay as of the first quarter of 2019. Following are some data points of particular interest. Hospice Admissions: Trella found that hospice admissions grew…

MedPAC Advances Hospice Cap Reforms, FY2021 Payment Recommendations

Initial Findings on Impact of Post-Acute Transfer Policy on Hospice Care On December 5 and 6, the Medicare Payment Advisory Commission (MedPAC) held a public meeting at which members discussed recommendations under consideration for inclusion in its annual MedPAC Report to Congress that is usually released in March.  MedPAC will finalize its recommendations at a…

OIG Updates Work Plan to Include Review of Hospice Inpatient and Aggregate Cap Calculations

On October 4, 2019, the Medicare Payment Advisory Commission (MedPAC) began discussions around potential reform of the hospice Aggregate Cap (Cap). MedPAC is considering a recommendation under which the Aggregate Cap would be wage adjusted for the first time in history but may also consider a reduction in the Aggregate Cap amount: at the October…

MedPAC Pushes for Aligning Payments, Regs, Benefits

The Medicare Payment Advisory Commission (MedPAC) recently convened for a session furthering their work on the development of a unified post-acute care prospective payment system (PAC PPS). In this most recent session, a focus was placed on the applicability of co-pays and potential requirements to access post-acute care (PAC) care via a required hospitalization. MedPAC staff…