The Centers for Medicare & Medicaid Services (CMS) has released its proposed rule updating payments to hospice facilities for fiscal year (FY) 2023. Comments on the proposed rule are due by 2 p.m. (PT) on May 31.
CMS proposes a net 2.7% ($580 million) increase in its payments for FY 2023. As in prior years, hospices that fail to meet quality reporting requirements receive a 2% reduction to the annual market basket update for FY 2023. The hospice payment update includes a statutory aggregate cap that limits the overall payments per patient that are made to a hospice annually. The proposed cap amount for FY 2023 is $32,142.65 (FY 2022 cap amount of $31,297.61 increased by 2.7%).
Given volatility in the hospice wage index, the rule proposes a budget-neutral approach to smooth changes. CMS proposes to permanently cap negative wage index changes greater than a 5% decrease from the prior year. This cap would apply regardless of the underlying reason for the decrease.
The rule also discusses several potential changes to the hospice quality reporting program (HQRP) and requests information related to health equity.
- Patient Assessment Instrument: CMS provides an update on the Hospice Outcomes and Patient Evaluation (HOPE), a new patient assessment instrument that will contribute to the plan of care once adopted. The rule also discusses potential future quality measures within the HQRP that are based on HOPE and administrative data, including HOPE-based process measures and hybrid quality measures.
- Consumer Assessment of Healthcare Providers & Systems (CAHPS) Hospice Survey: The rule provides an update on an experiment where the goal was to test the effect of adding a web-based mode to the CAHPS Hospice Survey.
- Health Equity Initiative Request for Information: CMS seeks information on its Health Equity Initiative within the HQRP by describing the agency’s current assessment of health equity within hospice. CMS also seeks input on a potential future structural measure as well as responses to specific questions that would further inform future efforts.
Additional information on the proposed rule is available in a CMS fact sheet.