Hospice providers will see a 1.1% increase in Medicare payments in fiscal 2016, according to a final rule issued Friday by the CMS.
That means that an additional $160 million will be spent by Medicare on palliative care, as the agency adjusts how much it will pay providers when patients spend more time in hospice. That's slightly lower than the 1.3% rate increase proposed by the CMS in April and still lower than the 1.4% payment hike it gave hospice organizations last year.
The rule creates a higher base payment rate for routine home care during the first 60 days of hospice care and a reduced base payment rate beginning on the 61st day of hospice care. It also provides for an add-on payment to fund more intensive care during the last seven days of a beneficiary's life, if certain criteria are met.
The new end-of-life payment doesn't change the overall amount hospitals will be paid in 2016 because it's compensated for by the reduction in the routine home-care rate. Both rates are effective in the new year.
The CMS reaffirmed hospices must report all diagnoses of the beneficiary on their claim as a part of ongoing data collection regardless of a terminal prognosis. The CMS said in the proposed rule that it was "concerned that some hospices are neither conducting a comprehensive assessment nor updating the plan of care as articulated by the conditions of participation to recognize the conditions that affect an individual's terminal prognosis."
Claims for the Medicare hospice benefit have grown substantially since it was implemented in 1983. In 2013, 1.3 million Medicare beneficiaries received hospice services, as compared with 513,000 in 2000.
At $15.3 billion in hospice expenditures in 2013, Medicare spent more than five times more on the benefit than it did in the millennium. Part of that is because of an increase in the average length of stay, which increased by 82% during the 13-year period.
