The Centers for Medicare & Medicaid Services this afternoon proposed a 2.6% update for hospices for fiscal year 2025 — an estimated increase of $705 million in payments from FY 2024.
This update reflects a 3% market basket percentage increase reduced by a 0.4 percentage point productivity adjustment. Hospices that do not submit the required quality data would be penalized with a -1.4% update — the proposed FY 2025 hospice payment update percentage of 2.6% minus four percentage points.
The rule also proposes a hospice cap of $34,364.85 (FY 2024 cap amount of $33,494.01 increased by the FY 2025 hospice payment update percentage of 2.6%).
Beyond financial changes for FY 2025, the proposed rule would adopt and implement the Hospice Outcomes and Patient Evaluation (HOPE) patient-level data collection tool, beginning with FY 2025, and replace the existing Hospice Item Set (HIS) structure.
“HOPE will collect data at multiple time points across the hospice stay, including admission, the HOPE Update Visit (HUV), and discharge,” CMS said in the proposed rule. “Compared to the HIS (which only collected data at hospice admission and discharge), HOPE will enable CMS to gather patient level data during their hospice stay to support quality measures. HOPE includes several domains that are new or expanded relative to HIS, including: sociodemographic (updated), diagnoses (expanded), Symptom Impact Assessment and Imminent death.”
This rule proposes adding two new process measures to the Hospice Quality Reporting Program (HQRP): Timely Reassessment of Pain Impact and Timely Reassessment of Non-Pain Symptom Impact, expected to begin in FY 2028. These process measures, which would use the data the HOPE instrument will collect, would reflect whether a follow-up visit occurred within 48 hours of an initial assessment where there was an impact of moderate or severe symptoms with and without pain.
This is a developing story. Please check back for updates.
