CMS Implements New Payment Structure for Hospice

On July 31, 2015, the Centers for Medicare and Medicaid Services released the FY2016 Hospice Wage Index Final Rule. Two payment reform changes will be put into effect on January 1, 2016 by the rule, a two-tiered routine home care (RHC) rate and a service intensity add-on payment. 

The two-tiered payment model for RHC days will pay hospices a higher rate for the first 60 days of hospice care and a lower rate for subsequent days in hospice care.

A service intensity add-on (SIA) payment will be made for patients receiving visits conducted by an RN or social worker during the last week of life when patients and families typically have more intensive needs. CMS will calculate and make the appropriate SIA payment based on a review, after a patient’s death, of hospice claims for the last seven days of the patient’s life. 

The National Hospice and Palliative Care Organizations applauds the new payment reforms and plans to work with CMS to ensure the change goes smoothly. Read more about the reforms and NHPCO’s comments here