In Extended Care & Home Health

Hospice and palliative care organizations that want to help shape relevant measures regarding care should act quickly on two opportunities, with respective deadlines of May 30 and June 26, 2018.

The first concerns the Hospice Evaluation Assessment Reporting Tool (HEART). The Centers for Medicare & Medicaid Services (CMS) has made grant funding available to help selected organizations define measures, but the deadline for grant submission is May 30.

The second opportunity is part of the FY 2019 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Requirements. The federal agency is seeking comments on quality reporting requirements. You can find more on the proposals here, including information on how to comment. Deadline for comments is June 26.

Hospice organizations are essential during this time to provide comments, and advocate on measuring what matters.

Grants for HEART Help

HEART represents a major change in how hospice patients are evaluated. A proposal calls for using relevant portions of the Hospice Item Set (HIS) in HEART, as well as additional clinical measures that haven’t been determined. Grant winners will help shape those measures. Organizations that have the capacity to submit grant proposals should do so, but time is short.

The hospice industry has been working toward new reporting requirements for several years. As CMS began to examine meaningful use, it became evident that many of the measures didn’t accurately reflect the specialty of palliative and/or hospice care services.

The American Academy of Hospice and Palliative Medicine (AAHPM) and the Hospice and Palliative Nurses Association (HPNA) collaborated on a project known as Measuring What Matters, completed at the end of 2014 and published in the Journal of Palliative Symptom Management in early 2015. At the time of the project, hospice and palliative care providers recognized it was critical to create a baseline.

The proposals released for FY2019 include what CMS calls “Meaningful Measures.” To find a full list of priorities and meaningful measurement areas, visit the CMS Meaningful Measures website.

Areas of particular interest to hospice and palliative care organizations include the quality priorities of promoting effective communication and coordination of care, and strengthening people and family engagement as partners in patient care.

Meaningful measurement areas under the first priority include medication management, admissions and readmissions to hospitals, and transfer of health information and interoperability.

The engagement priority includes these meaningful measurement areas:

  • Care is personalized and aligned with patient’s goals
  • End-of-life care according to preferences
  • Patient’s experience of care
  • Patient-reported functional outcomes

This final measurement area, patient-reported functional outcomes, should be particularly important to the industry. While hospice and palliative care are known for improving quality of life, that life generally is in decline.

Having the ability to articulate and demonstrate the decline in functional status in the terminal trajectory of an illness must be normalized. As defined by the World Health Organization, an individual’s functional status reflects their body structures, body function, their capacity and performance of activities, and whether their environment and health determinants are facilitating, neutral, or barriers to their health. This is applicable to all individuals, regardless of health conditions and in all physical, social, and cultural contexts.

Both initiatives have the potential to transform the delivery of palliative and hospice services. Make sure your organization’s voice is heard as these new quality and reporting measures are developed.

Rhonda Perrin Oakes, R.N., CHPN, is a Regulatory Analyst with Change Healthcare


Change Healthcare has unveiled InterQual 2018, the latest edition of the company’s flagship clinical decision support solution. This new release delivers updated and enhanced clinical criteria, as well as new disruptive technology for a more informed, collaborative, and streamlined healthcare ecosystem. Read the ...

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