Final FFY 2023 Hospice Payment Rule Increases Rates, Discusses Quality Initiatives

Hospice providers will see a Medicare reimbursement increase that is higher than that originally proposed earlier in the year. The Hospice Payment Final Rule, titled Medicare Program; FY 2023 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Requirements (CMS-1773-F), increases payments by 3.8 percent. This is up from the 2.7 percent figure in the proposed rule and is expected to increase funding by $825 million nationwide in Federal Fiscal Year (FFY) 2023. That makes the statutory aggregate cap $32,486.92, up from $31,297.61 in the current FFY. The Rule continues the use of the pre-floor, pre-reclassified hospital wage index data as the basis for the FFY 2023 hospice wage index while capping any single-year decrease in the wage index at 5 percent.

Along with payment provisions, the Final Rule discusses updates to the Hospice Quality Reporting Program (HQRP) that include the Hospice Outcomes and Patient Evaluation (HOPE) tool with national beta testing, the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Survey with Star Ratings, developing a web-based survey, public reporting, a request for information that builds from last year's discussion on health equity, updates on advancing a health information exchange, and updates on hospice survey and enforcement procedures.

While the FFY 2023 Hospice Rule does not add any new quality measures, it provides updates on previously adopted measures and initiatives, some of which are in the testing phase. Providers should keep in mind that those failing to report sufficient HQRP data are subject to a 2 percent reduction, which is scheduled to increase to 4 percent in FFY 2024. In addition, CAHPS Hospice Survey Star Ratings will be publicly reported on Care Compare on Medicare.gov beginning with the August 2022 refresh.

The Hospice Payment Final Rule Fact Sheet is here, a helpful article from LeadingAge National is here, and the text of the Rule is here.

Contact: Meg Everett, meverett@leadingageny.org, 518-867-8383 or Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841