The U.S. Centers for Medicare & Medicaid Services (CMS) has published a final rule on hospital discharge planning that underscores the need for hospices to leverage their publicly reported quality metrics as a competitive advantage.
The new rule requires hospitals to inform patients about their choices related to post-acute care providers including those organizations’ performance on quality and resource-use measures. While the quality data requirement does not apply to hospice, the move could incentivize sharing of hospice quality data, Theresa Forster, vice president for hospice policy for the National Association of Home Care & Hospice, told Hospice News.
“This rule raises the stakes relative to the quality metric scores reported on Hospice Compare, as it will drive broader use of it. It underscores the importance of hospices working to ensure their processes support continuing quality improvement and timely data filing,” Forster said. “It also means that hospice stakeholders must work directly with CMS to ensure that any hospice-specific information that is posted to [Hospice Compare] is clearly understandable and relevant for use by patients, families and referral sources.”
The principal quality metrics for hospice providers include the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey, which measures family members’ satisfaction with the services that their loved ones received, and the quality measures in CMS’ Hospice Item Set.
These metrics are reported on the agency’s Hospice Compare website. Referral partners and patients are increasingly using this information when selecting a hospice provider. In accordance with the new final rule, acute providers will soon be giving much of this information to patients directly.
Professionals in the hospice field largely praised the rule, but some further work may be necessary to advance its objectives.
“I think this rule is a step forward because it mandates that discharge planning focus on the patient’s goals and preferences, not just on hospital priorities. Publicly reported quality measures are a good thing, and they do give hospices a competitive advantage (as long as the individual agency’s metrics are good,” Brad Stuart, M.D., chief medical officer for the Coalition to Transform Advanced Care (C-TAC) told Hospice News. “More controversially, we also have to make sure important hospice metrics aren’t left out — for example, percent of hospice enrollees who receive a home visit within 48 hours of death. I don’t believe CMS employs this as a quality measure, and for-profits would lobby hard to keep CMS from using it because they are notoriously poor at it.”
Other provisions in the rule pertain to health care provider interoperability, requiring hospitals to provide patient health information to post-acute providers and to ensure that patients have access to their medical records in an electronic format.