Important Changes in the Hospice Item Set (HIS) Manual V3.00!

CMS has shared a new presentation that covers all the changes in the new Hospice Item Set (HIS) Manual. Click here to download the slides from the presentation, and continue reading for a quick summary of the major changes.

Before we dive in, let’s do a quick refresher on what the Hospice Item Set is. The HIS is one of two requirements for the Hospice Quality Reporting Program (HQRP). HIS data is combined with your hospice’s CAHPS data to give CMS and the public a summary of your hospice’s performance. Failing to comply with the requirements for HIS and CAHPS data reporting will result in a two percent reduction in your hospice’s annual payment update. Public measures are reported on Medicare Care Compare, the all-in-one replacement for Hospice Compare, which was recently retired.

CMS is continuing to design new measures and change current ones to use claims data, and the newest measure being changed is the “Hospice Visits when Death is Imminent (HVWDII)” measure. Data collection will no longer be done through clinician assessments, which will help to save providers some time. To accommodate this change, the new HIS Discharge Assessment no longer includes Section O (Service Utilization). Any Section O data sent to CMS will be ignored and will not impact your quality reporting or reimbursement.

As a reminder – data from quarters 1 and 2 of 2020 will not be used to determine your hospice’s 2022 payments. Only data from quarters 3 and 4 will be used due to the COVID-19 pandemic causing operational disruptions for most providers.

The QIES system is going away with the new iQIES system set to replace it in 2022. Your hospice’s reports will migrate to the new iQIES system and they will no longer be called CASPERs.

CMS is continuing to work on the new Hospice Outcomes and Patient Evaluation tool (HOPE). This is a real-time patient assessment tool currently undergoing testing with volunteer providers. It will incorporate data from the hospice item set, and will allegedly help hospices better serve patient and family care needs.