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Veteran Hospice Nurse's Opinion On The '16 Hospice Payment Rate Update

Posted by Danielle on August 05, 2015

We want your opinion. If you're involved in hospice care, you likely know all about CMS's Hospice Payment Rate update. The National Association of Home Care and Hospice (NAHC) compiled a  summary, which we've included for your convenience in italics. We want to know what you think about the rate update.

You can comment at the bottom of this post. To kick off the discussion, here's what our in-house veteran hospice clinician, Carleen, thinks of the update. 

I see the new payment structure as very positive for hospice providers. The first days of care and the last days of care are the most expensive for an organization. At the start of care, as patients and families acclimate to hospice, there's an increased need for clinical, spiritual and social worker visits and tasks. Toward the end of a hospice stay, pain and symptom management and emotional and spiritual needs increase and the care intensity typically increases accordingly. This new model supports the expense structure hospice already incurs. Good hospices have always been providing this level of service and will now be reimbursed accordingly. Those hospices that haven't been as good at providing that care will now have an incentive to improve. On a macro level, this will improve America's end-of-life care system and help patients receive higher care quality at the end of their lives. 

Carleen Rogers, RN, BS, CHPN


Hospice Payment Rate Update from NAHC.

On July 31, 2015, the Centers for Medicare & Medicaid Services (CMS) issued a final rule (CMS-1629-F) that updates fiscal year (FY) 2016 Medicare payment rates and the wage index for hospices serving Medicare beneficiaries. The FY 2016 provisions and other issues discussed in the final rule are summarized below.

Changes to Payments under the Medicare Hospice Benefit

Hospices will see an estimated 1.1 percent ($160 million) increase in their payments for FY 2016. The $160 million increase in estimated payments for FY 2016 reflects the distributional effects of the 1.6 percent FY 2016 hospice payment update percentage ($250 million increase), the use of updated wage index data and the phase-out of the wage index budget neutrality adjustment factor (-0.7 percent/$120 million decrease) and the implementation of the new Office of Management and Budget (OMB) Core Based Statistical Areas (CBSA) delineations for the FY 2016 hospice wage index with a one-year transition (0.2 percent/$30 million increase). The elimination of the wage index budget neutrality adjustment factor (BNAF) was part of a 7-year phase-out that was finalized in the “Medicare Program; Hospice Wage Index for Fiscal Year 2010” final rule (74 FR 39384, Aug. 6, 2009), and is not a policy change.

If you liked this post, you'd like our Q&A with Carleen about hospice misconceptions

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