HJAR Mar/Apr 2023

HOSPICE CARE INDEX RATINGS 26 MAR / APR 2023 I  HEALTHCARE JOURNAL OF ARKANSAS   Editor’s Note: Recently, CMS sought to develop newqualitymeasures (QM) to providemore information to better reflect care processes during a hospice stay and allow patients, families, and caregivers to make informed decisions. This new measure, the Hospice Care Index (which CMS also refers to as the HCI), is a QM comprising multiple indicators from Medicare claims data that are collected during a hospice stay. The index augments the Hospice Quality Reporting Program (HQRP) with new measurement domains that were either directly recommended by other federal agencies for CMS to publicly report or identified as areas for improvement during information gathering. The index currently monitors 10 indicators simultaneously, rather than measuring only a single aspect of care. This index characterizes hospices holistically, ensuring reliable provider rankings. 1 TheHCI helps consumers and referringproviders todifferentiatebetweenhospices and identifyhospice providers who consistently underperform. Indicators included in the HCI are: CHC (Continuous Home Care) or GIP (General Inpatient) provided; gaps in skilled nursing visits; early live discharges; late live discharges; burdensome transitions (type 1) — live discharges fromhospice followed by hospitalization and subsequent hospice readmission; burdensome transitions (type 2) — live discharges from hospice followed by hospitalization with the patient dying in the hospital; per-beneficiary Medicare spending; skilled nursing care minutes per routine hospice care (RHC) day; skilled nursing minutes on weekend RHC days; and visits near death. 1 Hospice Care Index Technical Report. Abt Associates for Centers for Medicare & Medicaid Services. July 1, 2022. https://www.cms.gov/files/document/hospice-care-index-hci-technical-reportjuly-2022.pdf Exhibit ES.1: Claims-Based Indicators Contributing to the Hospice Care Index. Hospice Care Index Technical Report (July 1, 2022): 3. Claims-Based Indicators Contributing to the Hospice Care Index