FY 2023 hospice payment rate update final rule solidifies payment increase and commitment to new patient assessment instrument

Rivet Blog Hospice

Beginning in FY 2023, hospice providers will see a payment increase of 3.8%, according to the FY 2023 hospice payment rate update final rule that the Centers for Medicare & Medicaid Services (CMS) announced on July 27, 2022. The rule was subsequently published in the Federal Register on July 29, 2022, and it takes effect October 1, 2022. Here are several highlights from the rule:

  • Hospices that fail to meet quality reporting requirements will receive a two-percentage point reduction to the annual hospice payment update percentage increase for the year.
  • The statutory aggregate cap for FY 2023 is $32,486.92. This is the maximum amount a hospice provider can receive per patient annually. Note: This amount has increased by 3.8%, up from $31,297.61 in FY 2022).
  • CMS has established a permanent, budget neutral five percent cap on any decrease to a geographic area’s wage index.

Note that in the final rule, CMS also discusses the development of a patient assessment instrument called the Hospice Outcomes and Patient Evaluation (HOPE). Here are a few things you should know about HOPE:

  • HOPE would contribute to the patient’s plan of care through patient assessments ongoing throughout the hospice stay.
  • HOPE is multidisciplinary: the assessment instrument would be completed by nursing, social work, and spiritual care staff.
  • HOPE alpha testing was completed at the end of January 2021.
  • CMS will use findings from the alpha test to inform decisions about the next draft of the HOPE assessment. This draft being tested in the national beta test that began in late fall 2021, and it will continue through 2022.
  • CMS anticipates proposing HOPE in future rulemaking after testing and analyses are complete.

How to prepare

Take a look at the 34-page rule, and begin conversations internally about what this payment increase might mean for your organization. Also, focus on quality reporting requirements to prevent payment reductions. It’s also helpful to review CMS’ proposals regarding the HOPE patient assessment instrument and contact CMS with questions and comments at HospiceAssessment@cms.hhs.gov. Still have questions? Rivet Health Law, PLC can help. Contact us for more information.