Posted Wednesday, June 30, 2021

In the FY 2016 Hospice Rate Update final rule, CMS established the service intensity add-on payment (SIA) for RHC when direct patient care is provided by an RN or social worker during the last 7 days of life. This additional payment was created to reflect higher costs associated with the last 7 days of life.

Since implementation of SIA in 2016, data shows that hospices have increased visits in the last days of life, behavior anticipated and encouraged by CMS to meet the “increased clinical, emotional, and other needs of the hospice beneficiary.”

Prior to SIA, CMS reported 93.2% of patients receiving Hospice benefits in RHC had a skilled visit from a nurse and/or social worker in the last three days of life. This number jumped to 95.6% in 2019.

Additionally, SIA payments have increased from $88 million in 2016, the first year of implementation, to $150 million in 2019. CMS has also added this measure to the publicly reported quality metrics for next year, signaling an ongoing intention to drive Hospice behavior towards specific patient care goals.

For more information on Hospice utilization trends, read the full 2022 Proposed Hospice wage index article here.

Call Corridor today to find out more about how you can leverage our documentation experience to help your agency meet this regulatory challenge. Click here or call us at 1-866-263-3795.


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