Hospice 2019 Final Rule

The New Year is approaching and so are new regulations that are going to be implemented on January 1, 2019.  Besides receiving an increase in reimbursement, hospices will also be facing new compliance tasks.

All providers are going to be excited about receiving an increase in reimbursement.  Hospices will see an additional 1.8% in reimbursement for 2019. The additional $340 million in funding for hospice is a gift from CMS with strings attached.

The aggregate cap for 2019 is also going to increase to $29,205.44 which is an increase of $516.40 from this year, 2018.

Compliance and ease of doing business as a hospice provider is getting a boost. Physician assistants will be recognized as attending physicians for hospice beneficiaries.  This regulatory change will not take effect until January 1, 2019.

Hospice Compare will undergo some changes. Seven (7) component measures will be reformatted and removed from one composite measure. CMS’ goal is to help consumers, patients and their families, to better understand the data and make it easier to review a provider’s quality.

Quality reporting will also be undergoing some changes. CMS is going to try to make it easier for hospices by setting the review and correction period for submission of data from the Hospice Item Set (HIS).  CAHPS participation for providers will also be extended.  NQF #3235 and hospice visits when death is imminent will also be paired together to allow users of Hospice Compare to easily review information.

CMS is introducing a new framework for quality measurement and to help improve CMS. The two-fold initiative is designed to focus on improving patient outcomes while at the same reducing the burden placed on agencies. The burden reduction will be designed to reduce paperwork for providers, but as some of us know all too well, that can be a double-edged sword.

The Final Rule for 2019 is an overall win for hospices. Providers will not only see an increase in reimbursement and an increase in the cap rate, but will also begin to see an easing of the burdensome regulations.  In order for providers to continue to be successful well into the remaining months of 2018 and the near year, hospices need to remember the basics.

Hospices need to keep in mind that while a rate increase may occur for 2019, a decrease could come in 2020.  While that isn’t likely, hospices need to make sure that overhead is always under control and waste is not prevalent.  The main goal is always to provide quality care to patients in a cost-effective manner that doesn’t compromise ethics.

Operating within the legal framework of an evolving industry can always be challenging and expensive. But, with the right group in place and the right policies in place, your hospice will continue to thrive for many years to come. Starting with this month’s edition of Hospice Today, we are going to focus on operational and financial aspects that your agency should review in the coming months to set the stage for a great 2019.  We value our reader’s input and welcome your thoughts and comments by phone or by email, hospice@tortolanoandco.com.

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