Hello everyone, and welcome to our Monday Minute. Today I’d like to discuss with you the Hospice Proposed Rule that’s been released for 2023. In this Proposed Rule, they have dealt with very many items that are pertinent, of course, to survival in Hospice.

The first one of what is usually to the forefront of everyone’s minds, is the rate adjustments,  are there rate increases or decreases, there will be a 2.7% increase in the rates that are paid to Hospices. That assumes, of course, that there’s not any changes when the Final Rule comes around, it could change within a point or two, but not typical that it will change dramatically.

In addition to that, they have also proposed to maximize the wage index changes to a maximum decrease of 5%. Which means basically, that if there were to be a recalibration of wage indexes, regardless of the reason, the areas that might be dramatically impacted by a decrease in the wage index would not have an effective decrease of greater than 5%. That is a big deal. There have been years when some areas have taken quite a huge hit, compared to the prior years.   Keep in mind that means basically that you know that your wage index will not be less than 95% of its current value in any subsequent year. So even if it were supposed to be 8% this year or the next year, it will be maximized at five and then the following year, it can’t drop again any more than an additional 5%. Hopefully, you understand the significance of that.

Another thing that that was addressed in the Proposed Rule was an update of sorts on the HOPE tool. The HOPE tool is a Clinical Assessment tool that’s been being worked on for years in Hospice, that will basically be similar to the OASIS Assessment in Home Health. When I say that, I say that only to compare them in the sense that there are comprehensive assessments of the patients with outcome measure questions that affect the outcome measures.

The HOPE tool has been through several levels of testing, beta testing currently.  After the testing has been finalized, they will then address the implementation of the HOPE tool, nationwide, in the form of rulemaking. Obviously, that’s not happening this year.  The earliest it could be in the Proposed Rule would be April 2023 to be finalized in August, for implementation in 2024. I’m not saying it’s going to happen that fast. I’m simply giving you the fact that the implementation would have to be addressed through rulemaking, a Proposed Rule and then Final Rule and that, obviously, is not going to happen this year.

There are multiple things within this Proposed Rule that you’re going to want to make sure you take a look at.  There were some suggested processes that CMS is going to look at and putting together committees, work groups, panels, technically is the right word, to help address some of the things that need to be looked at. One of those being Health Equity across the spectrum. So you’re going to want to make sure that you read and analyze this entire document and make sure that you participate in any of the coming webinars that might help you pull apart this Proposed Rule in even more detail. One that specifically comes to mind is one that will be occurring with the National Association for Homecare and Hospice, I believe on April 13.

Thank you all for participating today. I hope this has helped a little bit in opening up the window to the Hospice Proposed Rule for 2023. Thank you for being attentive to these Minutes. Stay tuned, of course as always, to your State and National Home Care and Hospice associations and hope to see you at a live event soon, like I did the people at the Illinois conference just last week. 

We would like to invite to join Melinda A. Gaboury, Leslie Heagy, Tammy Stewart and guest speaker Teresa Harbour, Senior Vice President, Accreditation at CHAP for the 2022 HPS Alliance Hospice Workshop on June 15-16, 2022 at the Franklin Marriott Cool Springs.