Hello everyone, and welcome to our Monday Minute.

Today we’re going to discuss the 2023 Final Hospice Payment Rule that was just released at the end of last week. There are several things within this Final Rule that were exciting, I guess you could say. There’s not many times that I would say a Medicare regulation is exciting, and I don’t know that some people would still use that, but the exciting part is that the rate changes were finalized at even higher than they were originally proposed. The Hospice Payment Rate Increase was originally proposed, earlier in April, at 2.7%, and this Final Rule brings an increase in payment of 3.8%, this is taking into account, a significant inflation adjustment, as I’m sure you can imagine, was needed.

We also have the cap change that was finalized for the wage indexes. So anytime they change a CBSA area, whether it’s moving the county from one CBSA to another, or changing the status of the CBSA area from urban to rural (or rural to urban) the wage index for the new CBSA area, in some cases, is a decrease from what the wage index would have been had the CBSA area stayed where it was. So, in that case, they are going to maximize the rate cut or the wage index cut at 5% when changes such as that occur. In the past, that’s been a temporary thing for one year, and then the full wage index adjustment was realized in subsequent years. Again, they have finalized that the maximum reduction in wage index, when changes and CBSA areas occur, will be 5%.

They have also updated the rates, and just to give you a little recap, Routine Home Care days 1-60 will be $211.34; 61 days plus will be $167. Continuous Home Care rate at $1,522.04, Inpatient Respite Care $492.10, and General Inpatient Care $1,110.76 – those are inclusive of the 3.8% increase in rates.

In addition, they have finalized the hospice cap amount for 2023 to be $32,486.92. They are also continuing to work on the HOPE Tool, which is the comprehensive assessment tool for hospice that will replace the HIS and will be a full clinical assessment tool. During the process of them continuing to work toward the finalization of the HOPE Tool, they are currently actively recruiting hospices to participate in the beta testing of the HOPE Tool. So, if you have any interest in that, and qualify, you should definitely look into that so that we can continue to move forward with the development of the HOPE Tool.

In addition to that, they are going to start publicly reporting the CAHPS Hospice Survey results in August 2022. There has been some concern over the number of surveys that are being returned by family members or descendants’ representatives. They are going to have information on the Care Compare site, where the publicly reported results will be found, regarding the fact that if you did not have enough surveys returned that you won’t have a star rating.  There won’t be any confusion why some hospices do not have a star rating if they did not have at least 75 completed surveys. They are also continuing to look into health equity and continuing to request that hospices submit comments and answer some of the key questions and components that they’re concerned about with health equity and the involvement of health equity in the assessment’s structure of the hospice outcome and composite measures.

Thank you so much for participating with us today. This Final Rule, unlike most, did have a little bit of a ray of sunshine. While 3.8% still seems small compared to what we really need to continue to maintain the inflation and costs that we are incurring, 3.8% is much better than 2.7% and much better than if we were to have had a reduction.

If there’s anything that we can, at Healthcare Provider Solutions, do for you, please don’t hesitate to let us know. Please make sure you stay connected to your state and national home care and hospice associations as they will continue to provide education on the results and impact of not only this Final Rule but all rules to come.

Thank you again, and I hope you have a fabulous week.

Link to Fiscal Year (FY) 2023 Hospice Payment Rate Update Final Rule (CMS-1773-F)