The revised Hospice Quality Reporting Program (HQRP) took effect in 2021, with a new claims-based quality measure replacing the previous quality-based Section O measure pair.
While hospice organizations can continue to record Section O data, adapting to the new quality measure through documentation in a regulations-compliant hospice software is essential to operational efficiency and revenue.
What Is the New Quality Measure?
The Hospice Visits in the Last Days of Life (HVLDL) measure only includes claim data for Medicare visits, based on visits by a registered nurse (RN) or medical social worker (MSW) in at least two of the last three days of life.
The Centers for Medicare and Medicaid Services (CMS) found that the HVLDL measure “demonstrates higher validity and variability testing results,” based on analysis of 100% of Medicare hospice claims data from fiscal year 2018.
Along with an improvement in quality scores, this new measure was mandated to reduce the burden of reporting for hospices, as no additional data is needed beyond what is already requested on claims.
What Changes in Claims Operations?
To save clinicians time and the organization money, it is important to use an intuitive hospice software that remains up to date on all medical regulations. Following CMS recommendations, Section O of the Hospice Item Set (HIS) is no longer available in Axxess Hospice to eliminate unnecessary documentation.
While CMS is permitting the use of Section O during the transition period, hospices can save time by prioritizing RNs’ and MSWs’ schedules to adhere to the regulatory changes, ensuring availability for the last three days of a patient’s life. Data has shown that it is during this time when patients exhibit highly specific physical signs associated with death.
Organizations should also add the visit types for RN and MSW visits within the hospice software to submit on claims prior to the first claim submissions.
The Interdisciplinary Group Still Matters
While the use of a chaplain, spiritual counselor or therapist is no longer required to be reported during these last days, it is beneficial for the patient and their family to have that option, so timely communication with the interdisciplinary group (IDG) is still imperative.
Using a hospice software that provides easy and HIPAA-compliant messaging between IDG members can help alleviate time constraints during the last days of life and expedite hospice visits.
When needed, providing these visits can also help with Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey scores, collected following a patient’s death.
Put Time and Money to Better Use
CMS has calculated that each Medicare-certified hospice admits roughly 283 patients per year. Eliminating Section O will save hospice nursing and clinical staff 4.2 minutes to abstract data from each HIS Discharge Record.
While 4.2 minutes may not sound extreme, that number equates to $1,414.25 of wages saved and 19.48 clerical hours eliminated annually. That money can be used for a monthly lease payment or purchasing new equipment, rather than spent completing unnecessary paperwork.
Selecting the correct hospice software can help organizations avoid wasting time and money. When Section O was necessary, Axxess Hospice users didn’t have to manually abstract any data, as this information was automatically compiled with a single click. Work smarter with a hospice software that has the health of the patient and the organization in mind.
Axxess Hospice is a cloud-based hospice software, accessible anytime, anywhere. Clinicians appreciate the ease of documentation from any device, while organizations thrive on the real-time data and reports available. Organizations of all sizes benefit from the HIPAA-compliant capabilities that provide complete transparency and total control of operations.
