CMS Releases Details of Two New Hospice Quality Measures

WASHINGTON, D.C. (October 12, 2021)—Hospice providers have been anxiously awaiting additional information on two new Hospice Quality Reporting Program (HQRP) measures:

•    Hospice Visits in Last Days of Life (HVLDL)
•    Hospice Care Index (HCI)

These are claims-based measures that the Centers for Medicare & Medicaid Services (CMS) has indicated will be publicly posted on Care Compare no earlier than May 2022. CMS has provided additional detail on these measures through a Hospice Quality Reporting Program User’s Manual, a Q&A document and updates to the Current Measures webpage. Measure specifications can also be found here.

Hospice providers can see their performance on the measures from the confidential Quality Measure (QM) reports now available via the hospice’s Community Assessment for Public Health Emergency Response (CASPER) folders in the Quality Improvement and Evaluation System (QIES) system. This data was of particular interest to hospices as, up until now, no national or individual hospice information was available and calculations for some of the indicators comprising the HCI cannot be duplicated or easily duplicated by hospices. The QM reports show the national benchmarks for three of the four measures that are part of the HQRP for 2021. These reports are not Preview Reports, meaning that the data contained there is not the data that CMS will post to Care Compare in 2022.

The Preview Reports will be available for review, as usual, approximately 30 days prior to the scheduled release of the data on Care Compare.

CMS has indicated that Care Compare will not include the HCI and HVLDL until at least May 2022. If released in May 2022, the HCI and HVLDL measure reporting period would begin with FY 2021 (Q1, Q2, and Q3 2021 and Q4 2020). The additional four quarters would be Q3 2020 and Q2, Q3, and Q4 of 2019—that is, past quarters adding up to eight quarters but omitting Q1 and Q2 of 2020 (exempted due to the public health emergency (PHE)). The data for the two claims-based measures will be updated annually in the fall and is also going to be available in the Provider Data Catalogue. While only the composite score for the HCI will be populated on Care Compare, a hospice’s individual performance on each of the ten indicators comprising the HCI will be accessible in the Data Catalogue. This is the same for the Comprehensive Assessment measure and its seven Hospice Item Set (HIS) components.

Hospice providers have been waiting to see how the PHE may have affected their performance. CMS has indicated that by using two years of claims data for the claims-based measures, it can reasonably state that the COVID-19 PHE affected hospices nationally in a similar way, despite regional differences in the timing of peaks in infection. To the extent there have been regional differences, CMS will report state averages so that consumers can appropriately benchmark hospices’ performance on HCI and HVLDL. Currently, the QM reports only contain national data.

Changes to the HQRP were effective Oct. 1, 2021 for Fiscal Year (FY) 2022. This year there are four HQRP measures:

•    HIS Comprehensive Assessment at Admission
•    Hospice Visits Last Days of Life
•    Hospice Care Index
•    CAHPS Hospice Survey

The National Association for Home Care & Hospice anticipates that the implementation of the HOPE (Hospice Outcomes & Patient Evaluation) tool, currently being tested, will bring many more measures to the HQRP. The HQRP QM Manual contains detailed information about the first three measures of the HQRP but not the CAHPS hospice survey. Information for this can be found on the CMS CAHPS Hospice Survey webpage.

The Quality Assurance Guidelines v8.0 for the CAHPS hospice survey is now available as are the training materials from the Sept.30, 2021 CAHPS Hospice Survey Update Training session. CMS is currently conducting a test of a shorter version of the CAHPS Hospice Survey which may result in changes to the survey in the future. However, CMS does intend to utilize the CAHPS Hospice Survey data for a star rating that is part of the HQRP in FY2022.

On Tuesday, Oct. 19, the Centers for Medicare & Medicaid Services (CMS) will host a webinar to share updates on the new claims-based measures for the Hospice Quality Reporting Program.

Webinar Details

•    Title: CMS October Hospice Quality Reporting Program Forum
•    Date: Tuesday, October 19, 2021
•    Time: 2:00 – 3:00 p.m. ET
•    Register here