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New Claim-Based Measures to be Included in CMS Hospice Quality Reporting Program

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CMS has finalized two new claims-based measures as part of the Hospice QRP: Hospice Visits in the Last Days of Life (HVLDL) and Hospice Care Index (HCI).

  • HVLDL measures the proportion of a hospice’s patients who have received in-person visits from a registered nurse or medical social worker on at least two out of the final three days of the patient’s life.
  • HCI is a single measure comprising ten indicators calculated from Medicare FFS claims data. The sum of the points earned from meeting the criterion of each indictor results in the hospice’s HCI score, with 10 as the highest possible score.

These data are collected based on care delivered. They will provide consumers with more direct information about decisions and actions made during the delivery of care than patient assessments or surveys.  CMS will calculate the claims-based measures using two years of data (eight quarters). Using two years of data, rather than one, allows CMS to publicly report the scores of more hospices with worse scores for HVLDL and HCI.  CMS will omit quarters 1 and 2 of 2020, the onset of the pandemic in the United States, from publicly reported claims-based measures. CMS will include data from quarter 3 2020 onward.

If released in May 2022, the HCI and HVLDL measure reporting period would begin with FY2021 (Q1, Q2, and Q3 2021 and Q4 2020). The additional four quarters would be Q3 2020 and Q2, Q3, and Q4 of 2019—that is, past quarters adding up to eight quarters but omitting Q1 and Q2 of 2020.  CMS will refresh claims-based measure scores on Care Compare, in preview reports, and in the confidential CASPER Agency-Level Quality Measure reports each year. Annual updates align with most claims-based measures across post-acute care settings.

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