Hospice Quality Reporting Program Update: HIS Timeliness Compliance Report Threshold

Posted Sunday, September 19, 2021

Hospices can now access their confidential Quality Measure (QM) reports in CASPER for two new publicly reported measures, Hospice Care Index (HCI) and Hospice Visits in the Last Days of Life (HVLDL). These two claims-based measures will be publicly reported on Care Compare no sooner than May 2022.

Hospices have been anxiously waiting to see the reports as no national performance data on either measure was available for hospices to use for benchmarking. Hospices must rely solely on CMS’ (Centers for Medicare & Medicaid Services) calculations of the HCI because hospital claims data is used for some of the indicators comprising this Index and hospices do not have access to this data.

According to the CMS notice about the QM reports being available claims from fiscal years 2018 and 2019 were used to calculate the measures. The CASPER Report User’s Guide has been updated to include the new reports.

In addition to the QM reports now being available, the Timeliness Compliance Threshold for HIS Submissions: Fact Sheet has been updated. This fact sheet outlines the timeliness compliance threshold for HIS (Hospice Item Set) submissions, details the algorithm for calculation and explains the associated CASPER report. It is especially prudent at this time for hospices to view their Timeliness Compliance Threshold report because the annual payment update penalty of two percent that is applicable to hospices that have not complied with the HIS and/or CAHPS Hospice Survey submission requirements jumps to four percent effective with the FY2024 payment year.

However, the HIS and CAHPS Hospice Survey submission period impacting the FY2024 payment year begins January 1, 2022, as noted below.

Annual Payment Update HIS CAHPS
FY2024 Submit at least 90 percent of all HIS records within 30 days of the event date (patient’s admission or discharge) for patient admissions/discharges occurring 1/1/22 – 12/31/22. Ongoing monthly participation in the Hospice CAHPS survey 1/1/2022 – 12/31/2022

Hospices not currently at the 90 percent HIS submission threshold should implement improvements now to ensure achieving the 90 percent prior to January 1. To determine if the CAHPS Hospice Survey data is being submitted by your CAHPS vendor as required, go to the CAHPS Hospice Survey Data Warehouse. More information on accessing the Warehouse is available here.

Hospices that have fewer than 50 survey eligible decedents/caregivers during January 1 – December 31, 2021, can request a participation exemption for size for 2022 submissions (which impact the FY2024 payment update).

 Source: CMS

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