NHPCO Launches Quality Connections Program

The National Hospice & Palliative Organization (NHPCO) in 2021 will launch a new large- scale initiative designed to help providers systematically assess and improve the quality of care they provide. The Quality Connections program will use didactic instruction and evidence-based tools to drive performance improvement.

NHPCO announced the program during National Hospice & Palliative Care Month. The scope of Quality Connections will go beyond the quality measures hospices are required to report to the U.S. Centers for Medicare & Medicaid Services (CMS) and will instead focus on development of organization-wide best practices.

“This has a lot to do with helping Congress, helping CMS and helping the general public understand that there are some hospice providers that are knocking it out of the park [on quality], that there are hospice providers that are really not trying, and there are hospice providers that are somewhere in the middle,” NHPCO President & CEO Edo Banach told Hospice News. “This is meant to help shine a light on those who are committed to excellence, are either going through the process of achieving excellence, or are excellent now and want to get even better. This is not about the Conditions of Participation. This is going above and beyond.”


The move comes at a time when hospices are coming under tighter and tighter scrutiny from regulatory agencies in matters of quality, billing and accurate documentation.

The Office of Inspector General (OIG) at the U.S. Department of Health and Human Services in late 2018 issued a report on payment-related vulnerabilities in the Medicare hospice program. Based on its findings, OIG recommended that the CMS strengthen the survey process and improve oversight to “identify hospices that engage in practices that raise concerns.” This was the first in a series of OIG reports throughout 2018 and 2019 that identified payment and quality-related problems in U.S. hospices. 

With more hospice reports in the works at OIG, providers can likely expect that regulators will continue to keep a close eye on the space, which could have a significant impact on organizations’ patients as well as their financial health. Other federal stakeholders, such as the Medicare Payment Advisory Commission have also raised quality concerns regarding hospice care.


“We’re trying to help folks be successful in continuous quality improvement [through Quality Connections]. It’s really using their own information, both clinical and operational, to help them identify the areas where they have opportunities for improvement, the impacts of different aspects of their program on that opportunity, and then create a plan that works to improve that quality, and track that over time. We’re trying to make doing the right thing easier,” said Lori Bishop, vice president of palliative and advanced care for NHPCO.

The NHPCO Quality Connections initiative is a one-year program, though provides can re-register for subsequent years. The organization expects more than 1,000 participants in its first year, according to Banach.

Throughout the 12-month program, participating providers will complete certain benchmarks within a designated timeframe for each of four programmatic pillars to achieve and sustain continuous quality improvement: Education, Application, Measurement and Innovation. The participating hospices will be encouraged to share the best practices they develop with their peers in the field to drive up quality industry-wide.

“As someone enrolls in the program, the first thing they’ll do for their organization is a self assessment. Once they complete that, it will guide them to other activities within the program that they should be doing based on where their organization is in terms of quality and understanding quality,” Bishop explained. “They’ll be guided to specific educational topics. Some of them are basic, some of them are CMS topics, and other online education and resources. Then there are some measurement tools that they’ll be guided to use that are also benefits to members.”

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