The agency plans to increase hospice payments by 2.3%, or $530 million, in 2022. The proposed aggregate cap for hospice payments is just under $31,390. According to a CMS fact sheet, CMS also plans to update the labor shares for continuous home care, route home care, inpatient respite care, and general inpatient care.
The agency proposed to make permanent a waiver it issued in response to the COVID-19 pandemic that allows the use of a pseudo-patient for hospice aide competency training. CMS also wants to allow hospices to carry out targeted competency evaluations to focus on a hospice aide's specific deficiencies and related skills.
"This will allow highly skilled aides to be trained more quickly in order to provide high-quality patient care while protecting patient health and safety," the agency said.
It also proposed to add consumer assessments of hospice providers under the Hospice Survey Star ratings to the Care Compare website.
"Star ratings benefit the public in that they can be easier for some to understand than absolute measure scores, and they make comparisons between hospices more straightforward," CMS said.
In addition, the agency plans to add a new measure to the Hospice Quality Reporting Program and adjust the Home Health Quality Reporting Program. It also asked the public to weigh in on improving hospice quality measurement using the Fast Healthcare Interoperability Resources standard.
According to a CMS fact sheet, skilled nursing facilities could also see their payments rise by 1.3% or $444 million.
CMS is also thinking about making changes to the Patient Driven Payment model and Skilled Nursing Facility Value-Based Purchasing program in response to the COVID-19 public health emergency. The changes include a proposal to zero out the readmission measure in the VBP program to avoid distorting performance scores and incentive payment multipliers, CMS said.
The agency is also looking for feedback on expanding the VBP's measure set, which Congress called for in its big spending package last December.
"CMS seeks comments on the measures listed in the proposed rule, including measures to assess residents' views of their healthcare and measures assessing staff turnover," the agency said.
In addition, CMS proposed to add two new measures to the Skilled Nursing Facility Quality Reporting Program. As with the hospice payment rule, the agency wants the public to weigh in on improving quality measurement for skilled nursing facilities using the Fast Healthcare Interoperability Resources standard.