In 150 words, substantively provide thoughts to Carole about her topic and ideas that may assist her in completing her project. Use at least one separate resource to add to the support of her post. Remember, your source should be less than 5 years. Don’t forget to reference your source. Carole’s topic as explained below;
The proposed quality improvement initiative from your place of employment that could easily be implemented if approved that I have chosen is the CMS – Hospice Quality Reporting Program in the last three and seven days of life. In hospice when a patient is on Medicare there are certain guidelines that are measured to assure quality care at end of life. These guidelines and measures are reportable to the public and can lead to reduced reimbursements from Medicare and Medicaid funding. Currently these measures are reportable in the last three days of life but after more review this will be extended to include the last seven days.
The FY 2019 Hospice Final Rule notes that the three-day hospice visits when death is imminent measure will be publicly reported in Hospice Compare in the summer of 2019. The three-day measure assesses the percentages of patients receiving at least one visit from an RN, Physician, NP or PA in the last three days of life. The seven-day measure which is not publicly released at present but is sure to be done in the future, measures the percentage of patients receiving at least two visits from a Social Worker, Chaplain or spiritual counselor, LPN, or hospice aide in the last seven days of life.
Why is this important to be completed? The HQRP includes data that is required to be submitted by hospices through the Hospice Item Set (HIS) data collection tool, data from Medicare hospice claims, and the experience of care survey called CAHPS. All Medicare-certified hospice providers must comply with both these reporting requirements. Because the HQRP is currently pay- for –reporting there must be timely and acceptable completion of that data the determines compliance with HQRP requirements. These requirements include both the HIS and CAHPS Hospice Survey. Since 2014 failure to comply with quality data reporting requirements have results in 2% points reduction but starting in 2024 that increases to 4%-point reduction. This amount can mean the difference between keeping the hospice financially viable or not. T
There is also a reporting website that the public can access to review the publicly reported quality measures of care provided by hospice and other health care providers. It is called Care Compare on Medicare.gov. I will review the number of deaths in our hospice in a certain time period and note how many patients received visits in the last three days of life as required for quality care per CMS guidelines and then present a plan for improvement and increased reimbursement from Medicare.
References
Centers for Medicare and Medicaid Services. (2021). https://www/cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Hospice-Quality-Reporting/index.html
CAHPS. (2021). Hospice Consumer Assessment of Healthcare Providers and Systems. https://www.hospicecahpssurvey.org/
