Hospice Quality Reporting

The Patient Protection and Affordable Care Act (ACA) mandated the initiation of a quality reporting program for hospices. The Center for Medicare and Medicaid (CMS) determines the quality measures that hospices must utilize and the processes hospices must use to submit data for those measures. Hospices that fail to submit required quality data in a given year will incur a 2 percentage point reduction to the market basket percentage increase for the subsequent fiscal year.

Hospice Quality Reporting

CMS maintains a Hospice Quality Reporting website with information on all aspects of the hospice quality reporting program. Be sure to check the CMS Hospice Quality Reporting website regularly for updated information and new resources.

2014: Hospice Item Set (HIS) – A patient-level data collection tool developed by CMS. Hospices are required to submit a HIS-Admission record and a HIS-Discharge record for each patient. Information collected through the HIS will be used to calculate hospices’ scores for 7 quality measures as listed:

Hospice Information Set (HIS)

The HIS is a patient-level data collection tool that will be used to collect data for 7 process measures:

  1. NQF #1617 Patients Treated with an Opioid who are Given a Bowel Regimen
  2. NQF #1634 Pain Screening
  3. NQF #1637 Pain Assessment
  4. NQF #1638 Dyspnea Treatment
  5. NQF #1639 Dyspnea Screening
  6. NQF #1641 Treatment Preferences
  7. Modified NQF #1647 Beliefs/Values Addressed (if desired by the patient)

For each patient admitted on or after July 1, 2014, completion of the HIS will be required on admission and on discharge.

  • Data collection period: July 1, 2014 – December 31, 2014
  • Data submission is on a rolling basis. Data submission process — TBA
  • Hospices that fail to report quality data via the HIS system in 2014 will incur a 2% market basket reduction for FY 2016 (starts October 1, 2015).

Each hospice will need two different user IDs when submitting HIS data to CMS; one user ID will be used for data submission, and the other will be used to retrieve data submission reports. Registration for these user IDs began on May 19, 2014. Hospices should register for these user IDs well in advance of the July 1st data collection start date to allow time for their user ID requests to be processed.

  • Data collection: 7/1/14 – 12/31/14
  • Data submission: 7/1/14 – 12/31/14
  • Penalty for failure to submit: FY 2016 (starting 10/1/15)

In preparation for Hospice Quality Reporting, it added many of the mandated fields in the 4th quarter of 2013 to collect the information for the HIS (Hospice Item Set) tracking.

With our Hospice Software, your hospice organization will be able to Capture, Track and Extract an XML file for submission to CMS.

See the System in Action. Request a Demo Today! Call 877 203 9444.

Sources:

NHPCO
http://www.nhpco.org/quality-reporting/
http://www.nhpco.org/quality/hospice-item-set-his/

CMS
https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Hospice-Quality-Reporting/index.html

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