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CMS Issues Final Rule on FFY 2022 Hospice Payment Rates

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The Centers for Medicare & Medicaid Services (CMS) has issued a final rule updating payments to hospice facilities for federal fiscal year (FFY) 2022.

CMS finalizes an annual payment update of 2% that includes a market-basket update of 2.7%, and a 0.7 percentage point productivity adjustment. These payment adjustments are estimated to result in an overall increase of 2% for hospice payments, or approximately $480 million compared to FFY 2021.  

The hospice payment update includes an update to the statutory aggregate cap that limits the overall payments per patient that are made to a hospice annually. The cap amount for FFY 2022 is $31,297.61. The FFY 2021 cap amount of $30,683.93 increased by 2.3%.  

In the final rule, CMS rebases and revises the labor shares for all four levels of care: continuous home care, routine home care, inpatient respite care, and general inpatient care based on the compensation cost weights for each level of care from the 2018 Medicare cost report data for freestanding hospices. The table below provides the updated share for each care setting.  

SettingLabor Share
Continuous Home Care 75.2%  
Routine Home Care 66%  
Inpatient Respite Care 61.0%  
General Inpatient Care 63.5%  

The rule also finalizes several changes to the hospice quality reporting program:  

  • Hospice Care Index: The Hospice Quality Reporting Program will contain a new measure called the Hospice Care Index that includes 10 indicators of quality calculated from claims data. This measure will be publicly reported no earlier than May 2022.  
  • Consumer Assessment of Healthcare Providers and Systems (CAHPS): CMS finalizes the addition of the CAHPS Hospice Survey Star ratings on Care Compare.   
  • Hospice Visits Last Days of Life (HVLDL): CMS finalizes the addition of the claims-based HVLDL measure for public reporting.  
  • Hospice Items Set (HIS): CMS finalizes the removal of seven individual HIS measures because a more broadly applicable measure, the Hospice Comprehensive Assessment Measure, is available and already publicly reported.    

CMS will take feedback it received from its request for information on closing the health equity gap into consideration as the agency works to develop policies to improve health equity. CMS plans to provide additional stratified quality measure information to providers related to race and ethnicity.  

In the final rule, CMS also finalizes changes to the hospice conditions of participation, including hospice aide competency evaluation standards. 

Additional information is available in a CMS fact sheet.