The Hospice Quality Reporting Program (HQRP) was created to evaluate a hospice provider’s response to the patient’s, family’s and caregivers’ needs and to ensure hospices have a solid foundation for providing quality care. The Centers for Medicare and Medicaid Services (CMS) determines the measures that will be used in the HQRP. The HQRP currently consists of four different quality measures: Hospice Care Index (HCI), Hospice Visits in the Last Days of Life (HVLDL), Hospice Item Set (HIS) and Consumer Assessment of Healthcare Providers and Systems (CAHPS).
Through fiscal year 2023, hospices face a 2% reduction in reimbursement for failure to meet requirements for HIS and CAHPS data submission, and in fiscal year 2024 the penalty doubles. Therefore, it is critical for hospice providers to understand, monitor and submit their quality data. This blog provides an overview of the four measures.
Hospice Care Index
The Hospice Care Index is designed to identify current hospice aggregate performance trends relative to other hospices. The HCI measures the hospice organization’s ability to address patient needs and care outcomes throughout their stay in hospice. HCI is a single measure comprised of 10 indicators calculated from Medicare claims data. Each of the 10 index measures is worth one point and will be calculated to inform a total score for the provider. An Axxess blog series reviews the ten indicators.
Hospice Visits in the Last Days of Life
Hospice Visits in the Last Days of Life is constructed from the Medicare hospice claim records. It assesses the number of visits made by a registered nurse or medical social worker on at least two of the last three days of life. The goal of the measure is to improve the quality of care provided in the last days of life when patients experience the most pain and symptoms. This measure only applies to patients receiving routine home care.
Hospice Item Set
The Hospice Item Set focuses on care processes to be completed at admission. Care processes include asking patients about hospitalization preferences, screening patients for pain, screening patients for shortness of breath and more. Patients must be 18 years old to be included in the calculation of the score. The threshold for reporting this measure is 20 admissions during a reporting period.
CAHPS
With the August 2022 Care Compare refresh, CAHPS survey scores were converted from a percentage to a star rating posted on the Care Compare website. The star ratings range from one to five stars, with one being the lowest rating. The goal of the star rating system is to provide consumers with an easy-to-understand method to summarize CAHPS scores and make the comparison between hospices easier. An overall summary score, the Family Caregiver Survey Rating, will be published for organizations that complete 75 or more surveys during a reporting period. The Family Caregiver Survey Rating is a summary star that reflects the average star rating the hospice received based on the top-box score for each measure included in the survey.
Quality of care touches every aspect of hospice; therefore, quality improvement should be the hub of every hospice organization. It’s important for hospices to have regular meetings to review their quality data and compare it to the HQRP regulatory requirements, benchmarks and organizational goals. Hospice providers that commit to this data analysis will find quality becoming an integral part of their organization.
To learn more about the HQRP, download the Axxess ebook.
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